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CPi # _ TO: ICE OF REVENUE AND RECOVERY . <br /> ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT.NO. <br /> REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE <br /> LAST - AKA - FIRST MI TITLE <br /> INDUSTRIAL MOBILE SERVICES <br /> GUARANTOR SSN <br /> C/O NAME <br /> JAMES A YATES <br /> CITY ST ZIP CODE AREA PHONE NO. <br /> MAILING STREET 209-610-8942 <br /> 2735 TEEPEE DR #BSTOCKTON CA 95205 <br /> CIN ST ZIP CODE AREA PHONE NO. <br /> RESIDENCE STREET <br /> OAKDALE CA 95361 209-465-7499 <br /> 13324 LAMBUTH RD <br /> USER REFERENCE NO. BILL STA CYCLE STATUS DATE BM CBMC INT MONTHLY PAY AMT <br /> 3115/06 <br /> 10479 HAZMIAT <br /> CHARGES <br /> LAST - RECIPIENT FIRST <br /> MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> - +�v <br /> SERVICE DATE: DATE OF �`r�/ O <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION <br /> AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 20061-1m p Annual Fee $240.00 <br /> 1 Chem @ $15.00 $15.00 <br /> 10% Late Charge $25.50 <br /> State Surcharge Fee $24.00 <br /> TOTAL $304.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> CITY ST ZIP CODE <br /> PRIOR STREET <br /> EMPLOYER PHONE NO <br /> EMPLOYER NAME <br /> INDUSTRIAL MOBILE SERVICES 209-610-8942 <br /> CITY ST ZIP CODE <br /> EMPLOYER STREET <br /> 2735 TEEPEE DR#B STOCKTON <br /> 9geE35i4 CO-OWNER CA 95205 <br /> LAST <br /> FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER PHONE NO <br /> EMPLOYER NAME <br /> 209-610-8942 <br /> INDUSTRIAL MOBILE SERVICES <br /> ECITY ST ZIP CODE <br /> EMPLOYER STREET <br /> CA 95205 <br /> 2735 TEEPEE DR#B STOCKTON �� <br /> CHDATE �b coL. zo <br /> ECK urea <br /> PREPARED BY (i(d( <br />