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CPG #f _ TO: � ICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL O Fly ACCOUNT NO. LL[ DEPT.NO. REFERRAL <br /> nATF <br /> 1 C <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> HUFFCOINC <br /> C/O NAME GUARANTOR SSN <br /> CHARLES DALE HUFF <br /> MAILING STREET CITY ST ZIPCODE AREA PHONE NO. <br /> 4447 S AIRPORT WAY STOCKTON CA 95206 209-983-4930 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 3541 LAKE FRONT CIR STOCKTON CA 95209 209-983-4930 <br /> USER REFERENCE NO. BILL STA CYCLE STATUS DATE BM CBMC INT I MONTHLY PAY AMT <br /> DUE QAT TERM DATE <br /> 10153 HAZMAT j 3/15/07 <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 CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONO <br /> 230 026000.0 2007 Hmmp Annual Fee $240.00 <br /> 6 Chems @ $15.00 Each $90.00 <br /> 10% Late Charge $33.00 <br /> State Service Fee $24.00 <br /> .Y'.•. 2� rA t, ' j�. <br /> TOTAL $387.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> HUFFCOINC 209-983-4930 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4447S AIRPORT WAY STOCKTON CA 95206 <br /> POLISH CO—OWNER <br /> LAST FIRST MI TITLEJ SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> HUFFCOINC 209-983-4930 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4447S AIRPORT WAY STOCZO CA 95206 <br /> PREPARED BlL CHECKED BY��yy DATE coy. 21 ryes <br />