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CPG�' _ TO: .,'FICE OF REVENUE AND RECOVERY .MOO <br /> ACCOUNT TRANSMITTAL nATP CPY <br /> /( 11ACCOUNT NO. DEPT.NO. REFERRAL �\\`V'J/J <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> QWEST COMMUNICATIONS CORP <br /> C/O NAME GUARANTOR SSN <br /> QWEST COMMUNICATIONS INTERNATIONAL, <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> QWEST COMMUNICATIONS CORP 1801 CALIFORNIA ST DENVER CO 80202 206-346-7532 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1801 CALIFORNIA STREET, SUITE 1160 DENVER CO 80202 303.902.7091 <br /> USER REFERENCE NO. BILL STA CYCLEI STATUS DATE BM CBMC INT MONTHLY PAY AMT <br /> 8778 HAZMAT <br /> 3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENTDOR USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. CHARGE <br /> NO DESCRIPTION AMOUNT DEPT.NO. DESCRIPTION AMOUNT <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 Surcharge Fee $24.00 <br /> \ L' <br /> TOTAL $337.50 <br /> GUARANTOR <br /> OPRIORSTRE <br /> NO AUTO LIC NO <br /> CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> QWEST COMMUNICATIONS CORP 206-346-7532 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 952 E LINDSAY ST STOCKTON CA 95202-2644 <br /> SPEWSH CO—OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> QWEST COMMUNICATIONS CORP 206-346-7532 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 952 E LINDSAY ST STOCKTON CA 95202-2644 <br /> PREPARED BY .y�7 CHECKED BY {j <br /> �'� T�-� �/ DATE��� coy. za ra�ea <br />