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CPG # TO: OFFICE OF REVENUE AND RECOVERY • (cO py <br /> A ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT. NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> VALLEY TOWING PRODUCTS <br /> C/O NAME GUARANTOR SSN <br /> RMP TOWING <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> VALLEY TOWING PRODUCTS 1313 S STOCKTON ST LODI CA 95240 209-368-8881 <br /> RESIDENCE STREET CITY ST ZIPCODE AREA PHONENO. <br /> 2250 THUNDERSTICK DR STE 1203 LEXINGTON KY 40505 859-294-5590 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM INT MONTHLY PAY AMT PYMT PR B <br /> 14402 HAZMAT <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. DESCRIPTION AMOUNT HARGE DEPT. NO. DESCRIPTION AMOUNT <br /> hir)230 1 026000.0 2010 Hazmat Fee $690.00 <br /> Hazmat Penalty Fee $69.00 <br /> TOTAL $759.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> VALLEY TOWING PRODUCTS 209-368-8881 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1313 STOCKTON ST LODI CA 95240 <br /> S-PAUS-P, CO—OWNER <br /> AST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> VALLEY TOWING PRODUCTS 209-368-8881 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1313 STOCKTON ST LO L CA 95240 <br /> REPARED BY CHECKED BY DATE ^/ COL. 2a (3rea) <br />