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CPG # 1 TO: 0ZCE OF REVENUE AND RECOVERY O <br /> ACCOUNT TRANSMITTAL 'IULrJJ <br /> ACCOUNT NO, DEPT.NO. <br /> REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE <br /> LAST - AKA - FIRST MI TITLE <br /> TIMBRON INTERNATIONAL INC <br /> GUARANTOR SSN <br /> C/O NAME <br /> TIMBRON INTERNATIONAL <br /> CITY ST ZIP CODE AREA PHONE NO. <br /> MAILING STREET 209-983-8393 <br /> 4331 POCK LN STOCKTON CA 95206 <br /> CITY ST ZIP CODE AREA PHONE NO. <br /> RESIDENCE STREET N/A N/A N/A 209-983-8393 <br /> N/A <br /> USER REFERENCE NO. BILL STA CYCLE STATUS DATE BM CBMC INT MONTHLY PAY AMT <br /> 3/6/04 <br /> 9613 HAZMAT <br /> CHARGES <br /> LAST - RECIPIENT - FIRST <br /> MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGEDEPT.NO. DESCRIPTION <br /> AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> Kin <br /> 230 026000.0 2004 Hmmp Anmual Fee $240.00 <br /> 5 Chems @ $15.00 Each $75.00 <br /> 10% Late Charge $31.50 <br /> State Service Fee $24.00 <br /> TOTAL $370.50 <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 /> 209-983-8393 <br /> TIMBRON INTERNATIONAL INC <br /> CITY ST ZIP CODE <br /> EMPLOYER STREET <br /> CA 95206 <br /> 4331 POCK LN STOCKTON <br /> R7. CO-OWNER <br /> LAST <br /> FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER PHONE NO <br /> EMPLOYER NAME <br /> 209-983-8393 <br /> TIMBRON INTERNATIONAL INC <br /> CITY ST ZIP CODE <br /> EMPLOYER STREET <br /> CA 95206 <br /> 4331 POCK LN STOCKTON <br /> CHECKED BY DATE .� � coy. 20 ryes <br /> PREPARED BYL <br />