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0 <br />Elite IV Contractors <br />253& Wigwam Dr. <br />Stockton, CA. 95205 <br />® PLACE IN SERVICE NOTICE <br />Phone: (209) 461-6337 <br />Fax: (209) 461-6342 <br />P.O.# / Work Order# ti�(�V-.> <br />NOTICE OF SALE, LEASE, LOAN <br />County Date q{ �} Service Agency Registration No. <br />'ja' x <br />t,.nr_ dTrnv nor nRZRrr <br />Name of Customer <br />Address <br />City <br />'zip <br />Caere. of Coot No. <br />Out of order <br />vvvvt-iwwA-_ r%n ,►arrwernDTwr nwyyfyQ lPi_errwn TV t'Rl?VTVR <br />Caere. of Coot No. <br />Out of order <br />My ce <br />MUM&Ctufar <br />MW Number <br />SaWNtuatber <br />Devi= type <br />(� vi�� <br />C&P{'Y <br />T&SNumber <br />Locadw <br />i <br />tr r�. <br />Re WICS: <br />yj <br />1 <br />. <br />i.Fi <br />{� <br />�` w,� � ,>I Yl f�,. tr <br />f..'�r. `• -i 0...%gym <br />j <br />5, .,. a,4 �...d <br />� <br />Av: <br />Bio t � , ,� <br />�� �..� � .r .a . � �—1 t �_ ► -. ..��'- <br />� � �..�`�. "�: <br />Tagg <br />Date placed in wM ice <br />Date this notice was: ❑ <br />Mailed <br />Ca Yea <br />.6 No (if no explain in rwarlas) <br />t ( h' l r . t <br />% ❑ <br />Faxed <br />Print Name of Service Agent <br />Signature of Service Agent <br />Service Agent's Licease No. <br />