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CPG # TO: 00E OF REVENUE AND RECOVERY � <br /> ACCOUNT TRANSMITTAL COPY ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> ROLLING FRITO LAY SALES <br /> C/O NAME GUARANTOR SSN <br /> FRITO LAY INC <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> ROLLING FRITO LAY SALES 4029 LECKRON RD MODESTO CA 95357 209-544-5427 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 7701 LEGACY DR PLANO TX 75024 972-334-7000 <br /> USER REFERENCE NO. I BILL STA CYCLE STATUS DATE BM CBMC INT I MONTHLY PAY AMT <br /> 9579 HAZMAT I I I I I I I I I I I I 1 11 4/15/06 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> DOB <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 2006 Hmmp Annual Fee $240.00 <br /> 6 Chems @ $15.00 Each $90.00 <br /> 10% Late Charge $33.00 +s <br /> State Service Fee $24.00 <br /> Sm Hw Gen <5 Tons/yr $200.00 <br /> Permit Fee Penalty $200.00 <br /> TOTAL $787.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ROLLING FRITO LAY SALES 209-544-5427 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1190 SPRECKELS RD MANTECA CA 95336 <br /> 9Peb%SH CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ROLLING FRITO LAY SALES 209-544-5427 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1190 SPRECKELS RD MANTTEr^CA CA 95336 <br /> PREPARED B��ZV CHECKED BY DATE C12 <br /> 710 COL. 20 (Wee <br />