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CPG # T0: *CE OF REVENUE AND RECOVERY C• <br /> ACCOUNT TRANSMITTAL ® p <br /> ACCOUNT NO. DEPT.NO. REFERRAL <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 STA CYCLE STATUS DATE BMCj CBMC INT I MONTHLY PAY AMT <br /> DUE DATE I TERM DATE <br /> 12462 HAZMAT 7/15/07 <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 2004-2007 Hmmp <br /> Annual Fee $960.00 <br /> 3 Chems @ $15.00 <br /> Each Year $180.00 <br /> 10% Late Charge $114.00 <br /> State Service Fee $24.00 <br /> Payment -$319.50 <br /> TOTAL =4$958 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY Si ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ALL AMERICAN MUFFLER&PERFORMANCE INC' 209-993-6003 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 720 E HAMMER LN STE B-4 STOCKTON CA 1 95210 <br /> SPE)US$ CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO, I DOB I 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 HAMMER <br /> �L/N�STE 8-4 STOCKTON CA 95210 <br /> PREPARED BY CHECKED BY,� y�_ DATE p O� COL. 20 (WSB <br />