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TO: W ICE OF REVENUE AND RECOVERY 0 /� O <br /> ACCOUNT TRANSMITTAL '\(\V_ <br /> ACCOUNT NO. DEPT.NO. REFERRALAT <br /> U <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> ALL AMERICAN MUFFLER& <br /> C/O NAME GUARANTOR SSN <br /> CHRIS ORTEGA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 720 E HAMMER LN STE B-4STOCKTON CA 95210 209-993-6003 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2410 MODOC WAY LODI CA 95242 209-993-6003 <br /> USER REFERENCE NO. BILL STAI CYCLE STATUS DATE BM CBMC INT I MONTHLY PAY AMT <br /> 12462 HAZMAT I I I I I I I I I I I I I I I I I I I j 3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> DOS <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONO <br /> 230 026000.0 2008 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $28.50 <br /> State Service Fee $24.00 <br /> TOTAL-----4$337.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ALL AMERICAN MUFFLER&PERFORMANCE INC 209-993-6003 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 720 E HAMMER LN STE B-4 STOCKTON CA 95210 <br /> &PeHSR CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ALL AMERICAN MUFFLER&PERFORMANCE INC' 209-993-6003 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 720 E HAMMERUN <br /> STE B-4 STOCKTON CA 95210 <br /> PREPARED By CHECKED BY - JD ATE �Q Coy. 20 ranee <br />