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CPG # TO: ( ICE OF REVENUE AND RECOVERY ...J C O [py <br /> .� ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 DATE <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> FIVE STAR EXPEDITERS INC <br /> C/O NAME GUARANTOR SSN <br /> ARCHIE R MEND <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> FIVE STAR EXPEDITERS INC P.O.BOX 30158 STOCKTON CA 95213 209-938-0117 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 3661 WOOD DUCK CIRCLE STOCKTON CA 95207 209-938-0117 <br /> USER REFERENCE NO. I BILL STA CYCLE STATUS DATE BM CBMC INT MONTHLY PAY AMT <br /> AT RM DATE <br /> 11245 HAZMAT 3/15/07 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENTDOR USER REFERENCE NOMARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2007 Hmmp Annual Fee $240.00 <br /> 9 Chems @ $15.00 Each $135.00 <br /> 10% Late Charge $37.50 <br /> State Surcharge Fee $24.00 <br /> TOTAL $436.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> FIVE STAR EXPEDITERS INC 209-938-0117 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1617 E MAIN ST STOCKTON I CA 1 95205 <br /> ePeVSH CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> FIVE STAR EXPEDITERS INC 209-938-0117 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1617 E MAIN ST STOCKTON CA 95205 <br /> PREPARED B CHECKED BY DATE �! !0 7 COL. 20 rase <br />