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CPG•# T0: OCE OF REVENUE AND RECOVERY � <br /> COPY <br /> TRANSMITTAL <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> AAMCO TRANSMISSIONS <br /> CIO NAME GUARANTOR SSN <br /> ECO AUTO TECH INC <br /> MAILING STREET CITY ST ZIPCODE AREA PHONE NO. <br /> AAMCO TRANSMISSIONS 2589 E WATERLOO RD STOCKTON CA 95205 408.859.2319 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 40 RAFEAL DR SAN RAFAEL CA 94901 415.328.2141 <br /> USER REFERENCE NO. I BILL hTAT CYCLE STATUS DATE BMd CBMd INd MONTHLY PAY AMT <br /> 13513 HAZMAT 3/15/12 <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> r123 <br /> STOP MED REC NO CHARGE <br /> DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 042000.0 2012 Hazmat Fee $115.00 8P43009.01 <br /> 1 014290010 1 Hazmat Penalty Fee $11.50 p8q4 oo .o <br /> p8q I q4290010 I Sm Hw Gen <5 Tons/yr $213.00 p8q <br /> p8q 1 014290010 Permit Fee Penalty $213.00 p8q <br /> 80 0 2 q0010 I State Surcharge Fee $24.00 p8q <br /> 1 1 <br /> 80 0 2 00 o Electronic Surcharge Fee $25.00 8P43009.01 <br /> 1 1 <br /> 80 0 2 00. 8 4 009.0I <br /> TOTAL 1 $601.50 <br /> DOR nRIICNQ At Fro I IC-UQ--- <br /> p F <br /> PRIOR STREET ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE N11 <br /> AAMCO TRANSMISSIONS 408.859.2319 <br /> EMPLOYERSTREET CITY ST ZIP CODE <br /> 2589 W WATERLOO RD STOCKTON CA 95205 <br /> ST FIRST MI TITLE SOC SEC N0, DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> AAMCO TRANSMISSIONS 408.859.2319 <br /> EMPLOYERSTREET 71P rnnF <br /> 2589 W WATERL O D T TON CA 95205 <br /> 1pgppAgFn CHECKED B JDATE COL. 20 (3/88) <br />