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Dung Phan And Nhuan Le -3- <br /> If you believe that you qualify, you may request the Fund review your claim to detennine eligibility for <br /> Priority Class "B". In order to determine eligibility, the following documents must be submitted and <br /> reviewed: <br /> • Complete the Enclosed form "Request for Assignment of Claim to Priority Class B". <br /> AND <br /> • Submit the three previous years of complete federal tax returns. Refer to the enclosed "Chart of <br /> Required Federal Tax Returns" to detennine all federal tax forms that must be submitted. <br /> AND <br /> • Submit documentation supporting the number of employees for the claimant, claimants business and <br /> any affiliates (i.e. Department of Employment Development(DE6)payroll reports for the last four <br /> quarters). If you have no employees, provide a signed/dated declaration underpenalty ofperjury <br /> letter stating so. <br /> NOTE: Failure to respond to this request within thirty(30) calendar days from the date of this letter may <br /> result in an ineligibility determination of your claim. Enclosures with the Fund's previous letter will not <br /> be duplicated with this letter. <br /> If you have any questions,please contact me at(916) 341-5761. <br /> Sincerely, <br /> Barbara Rempel <br /> Claims Review Unit <br /> Underground Storage Tank Cleanup Fund <br /> cc: Mr. Brian Newman ►BMs. Margaret Lagorio <br /> RWQCB, Rea. 5 - Sacramento San Joaquin County EHD <br /> 11020 Sun Center Drive 304 E Weber Ave, 3rd Floor <br /> Rancho Cordova, CA 95670 Stockton, CA 95202-2708 <br /> C,?/ifornia Environmental Protection Agencj, <br /> �.r�Recycled Paper <br />