Laserfiche WebLink
' CPG,# TO: ICE OF REVENUE AND RECOVERY PY <br /> ACCOUNT TRANSMITTAL �O ACCOUNT NO. - DEPT.NO. nATF <br /> REFERRAL \�\J. <br /> 026000.0 8/8/03 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> RAMIREZ AUTOMOTIVE <br /> C/O NAME GUARANTOR SSN <br /> JUAN RAMIREZ <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 811 N SACRAMENTO ST LODI CA 95240 209-367-4332 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 315 S STOCKTON ST LODI CA 95240 209-367-4385 <br /> USER REFERENCE NO. BILL STd CYCLE STATUS DATE BMd CBMC INT MONTHLY PAY AMT <br /> DI IF nATP TERM DAT <br /> 6584 HAZMAT 7/27/03 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> nnA <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 2003 Hmmp Annual Fee $240.00 Previously <br /> 3 Chems @ $15.00 Each $45.00 a erre : <br /> 10% Late Charge $28.50 9/10/02 - Unpaid <br /> TOTAL $313.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> RAMIREZ AUTOMOTIVE 209-367-4332 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 811 N SACRAMENTO ST LODI CA 95240 <br /> 9P0H9£ CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> RAMIREZ AUTOMOTIVE 209-367-4332 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 811 N SACRAMENTO ST LODI CA 95240 <br /> PREPARED B/Y,' . , CHEC DATE 8/8/03 <br /> �,Cl' I C.L �rLti 'aGU COL 20 (N88: <br />