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C2G # TO: ( ICE OF REVENUE AND RECOVERY *moo <br /> —` ACCOUNT TRANSMITTAL COPY ACCOUNT NO. DEPT.NO. REFERR DATE 02600.0 AL <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> IDEAL QUARTZ MACHINING INC <br /> C/O NAME GUARANTOR SSN <br /> JONATHAN SMITH <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 17990 IDEAL PKWY MANTECA CA 95336 209-824-1944 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2708 PALOMINO LN MODESTO CA 95355 209-576-8615 <br /> USER REFERENCE NO. I BILLI SjAj CYCLE1 STATUS DATEI BM CBMCI INT I MONTHLY PAY AMT <br /> 10072 HAZMAT I I I I I I I I I I I I I I I I I I 1 11 3115107 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> DOR <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 2007 Hmmp Annual Fee $240.00 <br /> 5 Chems @ $15.00 Each $75.00 <br /> 10% Late Charge $31.50 <br /> State Service Fee $24.00 <br /> TOTAL $370.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> IDEAL QUARTZ MACHINING INC 209-824-1944 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 17990 IDEAL PKWY MANTECA CA 1 95336 <br /> SPAHSH CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> IDEAL QUARTZ MACHINING INC 209-824-1944 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 17990 IDEAL PKWY MAN TEC CA 95336 <br /> PREPARED BY I CHE IDATE / ( /o;;> COL 20 (area <br />