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CFv # TO: O' --E OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT.NO. REDATE <br /> FERRAL i <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> MAIN ST MUFFLER <br /> C/O NAME GUARANTOR SSN <br /> EULALIA PENA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 3403 E MAIN ST CSTOCKTON CA 95205 209-478-8166 <br /> RESIDENCE STREET CITY ST ZIPCODE AREA PHONENO. <br /> 8419 FALKIRK DR STOCKTON CA 95210 209-478-8166 <br /> USER REFERENCE NO. I BILL STA CYCLE STATUS DATE BM CBMC INT I MONTHLY PAY AMTDAT TERM DATE <br /> 10990 HAZMAT 4/15/06 <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 /> NO <br /> 230 026000.0 2006 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $18.10 <br /> State Service Fee $24.00 <br /> Sm Hw Gen <5 Tons/yr $200.00 <br /> Permit Fee Penalty $200.00 <br /> Payment - 3/29/06 -$128.00 <br /> TOTAL $599.10 <br /> GUARANTOR <br /> DOB DRLICNO---F AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> MAIN ST MUFFLER 209-478-8166 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 3403 E MAIN ST C STOCKTON CA 95205 <br /> SPeUSE CO-OWNER <br /> LAST FIRSTMI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> MAIN ST MUFFLER 209-478-8166 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 3403 E MAIN ST C STOCKTON CA 95205 <br /> PREPARED BY •// CHECKED BY DATE �/ 71� 6 <br /> COL. 20 1388 <br />