Laserfiche WebLink
CPG'# T0: OFi'TCE OF REVENUE AND RECOVERY O CPY <br /> ACCOUNT TRANSMITTALO <br /> ACCOUNTNO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> ABOVE ALL AUTO REPAIR <br /> C/O NAME GUARANTOR SSN <br /> RICHARD COSTELLO <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2151 COUNTRY CLUB BLVD STOCKTON CA 95204 209-466-2715 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 209-466-2715 <br /> PYMT PROS <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM IN MONTHLY PAY AMT <br /> 14144 HAZMAT 3/15/12 <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICED TE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 230 042000.0 2012 Hazmat Fee $100.00 8 1 P43009.01 <br /> 30 1 042 00 0 I Hazmat Penalty Fee $10.00 8 1 P4300P.0 <br /> p8q I q429OOtO I State Surcharge Fee $24.00 8 1 P43009.01 <br /> p8q I 0 2 00 0 Electronic Surcharge $25.00 8 1 P43009.01 <br /> 6 02000 p8q 1 P43009.01 <br /> 80 0 290010 8 4 00 .0 <br /> 8 002qOO.p p8q4 00 .0 <br /> TOTAL $159.00 <br /> GUARANTOR <br /> PRIOR STREET qT ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ABOVE ALL AUTO REPAIR 209-466-2715 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2151 COUNTRY CLUB BLVD STOCKTON CA 95204 <br /> AST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ABOVE ALL AUTO REPAIR 209-466-2715 <br /> EMPLOYERSTREET CITY 71P rc)nF <br /> 2151 COUNTRY C U B D CKTON CA 95204 <br /> D COL. M (3188) //)/ <br />