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CPG # TO: 7ICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL COPY <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> BROWER DURABLE TRANSMISSIONS, <br /> C/O NAME GUARANTOR SSN <br /> C RAY BROWER <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1204 ENTERPRISE ST STOCKTON CA 95204 209-610-6075 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 3118 ESTATE DRIVE STOCKTON CA 95209 209-610-6075 <br /> USER REFERENCE NO. I BILLI STAI CYCLEI STATUS DATEI BM CBMC INT I MONTHLY PAY AMTIF DATE PRO <br /> 732 HAZMAT 3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> nnR <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> LNO230 <br /> DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 026000.0 2008 Hmmp Annual Fee $70.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $11.50 <, <br /> State Surcharge Fee $24.00 '; <br /> Sm Hw Gen <5tons/yr $213.00 <br /> Permit Fee Penalty $213.00 <br /> TOTAL $576.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST LP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> BROWER DURABLE TRANSMISSIONS, INC 209-610-6075 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1204 ENTERPRISE ST STOCKTON CA 95204 <br /> 3POLTSB CO-OWNER <br /> LAST FIRST MI TITLEJ SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> BROWER DURABLE TRANSMISSIONS, INC 209-610-6075 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1204 ENTERPRISE ST STOCKTON CA 95204 <br /> PREPARED BYI CHECKED B DATE COL. 20 (3188 <br />