Laserfiche WebLink
CPG # TO: OFFICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL <br /> b <br /> ACCOUNT NO. DEPT. NO. REFERRAL <br /> I 3N 042000 0 Z p <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> ELON INC(CLOSED) <br /> C/O NAME GUARANTOR SSN <br /> RICHARD EVANS Robert Evans, Manager <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 17333 S COMCONEX RD MANTECA CA 95336 209-481-5180 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 891 MONTICELLO LANE MANTECA CA 95336 209-481-5180 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM INT MONTHLY PAY AMT Y T B <br /> 12138 HAZMAT 3/15/09 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOINARRATIVE <br /> SERVICE DATE: DATE OF Tax ID$ <br /> START I STOP MED REC NO CHARGE <br /> ol 49 P91 91 29 0 <br /> CHARGE DEPT_NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 230 026000.0 2009 Hmmp Annual Fee $240.00 <br /> 230 026000 6 Chems @ $15.00 Each $90.00 <br /> 30 q2q00,0 10% Late Charge $33.00 <br /> 80 9400pState Surcharge Fee $24.00 <br /> 80 94 00,0 Sm Hw Gen<5tons/yr $213.00 <br /> 80 9400pPermit Fee Penalty $213.00 <br /> Invoice 8 184707 <br /> TOTAL $813.00 <br /> GUARANTOR <br /> 006 DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ELON INC(CLOSED) 209-481-5180 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 17333 S COMCONEX RD MANTECA CA 95336 <br /> SPQUSE CO—OWNER <br /> AST FIRST MI TITLE SOC SEC NO. I DOB DR LIC NO AUTO LIC NO <br /> I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> ELON INC(CLOSED) 209-481-5180 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 17333 S COMCONEX RD MANTECA CA 95336 <br /> REPARED BY CHECKED DATE ( 30 0 7 coy. zo Iaree1 <br /> I `' vim' \ __ / ✓ <br />