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CPG # TO: ICE OF REVENUE AND RECOVERY <br /> w.� ACCOUNT TRANSMITTAL <br /> ACCOUNT NO, D . REFERRAL <br /> 026000.6000.0 DATE <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> CASTLE AUTOMOTIVE <br /> C/O NAME GUARANTOR SSN <br /> HECTOR HERNANDEZ <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2315 N EL DORADO ST STOCKTON CA 95204 209-465-0171 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 209-465-0171 <br /> USER REFERENCE NO. IBILLI STAI CYCLEI STATUS DATE BM CBMCJ INT IMONTHLY PAY AMT <br /> 10515 HAZMAT 3/15/07 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE <br /> NO DEPT.NO. DESCRIPTION AMOUNT <br /> 230 026000.0 2007 Hmmp Annual Fee $70.00 ,; y. <br /> 2 Chems @ $15.00 Each $30.00 <br /> 10% Late Charge $10.00 <br /> State Service Fee $24.00 <br /> TOTAL $134.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> CASTLE AUTOMOTIVE 209-465-0171 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2315 N ELDORADO ST STOCKTON CA 95204 <br /> OFeUOH CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> CASTLE AUTOMOTIVE 209-465-0171 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2315 N EL DORADO ST STOC ON CA 95204 <br /> PREPARED BY I CHECKED BY b 7 TE COL. 20 f&88 <br />