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<br /> 1 f"faa, Rom sl;_>Wd be wmq,kvid by dome tlru PERAF APPUCADWor the 1XICAL A( i,° .Y
<br /> 1't NK IN SPI 3`'R
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<br /> . . ro an EK) in Me Fox MY to We urn that beat de,.b"E Q. ' n the I€>r<r. is t t.,a= coinfaeba
<br /> L 1_Sl''If.I FTISI`' 11 It:)Rh fXX`I1.I rk
<br /> Il carr€I • zuac mW addmos QW& at on) of the undupound UmMsy
<br /> Ntess MUS F ha e F aNd ph vVa_ location including ct',r Bei amf Ap,err'di.
<br /> Include vita ..st _ome strao and uarire of t o (Tct ttor.
<br /> 2, Phone number must have an .rr,vrt avozlar, If An rril;Sat umber is Ac asmq WIC °,.I:r-tl, tRr PuIr (crcxlrhm; ,,
<br /> >. Cheek tlle,"prnfirnw, hox"f:a -F-V E OF F3L,`IN SIS OWNERSHIP NERSEiIP f:�:If;I'1SILr�" iON, INDI 'II:�UAl NO)
<br /> i> C acl t?rG alrlr ap {r v ns f IFr" oI I suN F
<br /> s. lt` .l,t _ .. , K Indian or other Wan .._t lavol5. Beck e fam n Wd
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<br /> C;orstf.Iet alI ;t a M Moswoo, uyses aM 4enis an Am sarV t; jf f.I`IlW .1: iforho some, wrid 'SAA kS MIT sa ,E,r,.
<br /> fuss acts ions e s,.. . to c, vk PROPERTY .BIW box,
<br /> 11 "I'tyNK OWNFUI UNFU MA11 , ` Si, h F DItF k rI °>t ;rs y
<br /> I,or.rIata;'ral L.;tr� in 0h,. >z.�t,m. wAss A R"n am On a,r.e as .:tX ;iI rN .. of the ,.%tee.nn_.,_ ",SdI A,� SI lr d
<br /> this ,s"e£°(:9.ore Be sum to .f2k,,. .. ;ti t5'.;rf1; Ifk'TYPE,` r€r:
<br /> Den 1MRD OF MUAIXZA710N I.'FF tr r`f &AG , K31', ACCO'IJIS'I'NIJIMUTIit dsw 111? covpl.l?r ))
<br /> Wwr y&r Baud of 'eEciAloath 1, da OE) Ma swange fee account iluniber which is required before your p<.mrttt pficelion
<br /> mn be pxocessed Reginarerwcr , ah be trOU moi€ cmum Wt on W r i.ea&c a clta mtrarly swrage Beae;txim in .e,gran g me
<br /> ,M006i (d MR) per gallon Icr; alu on l re nuniber of q Ho placed in your CBI's, °9ltt: BOH W '<stte, persons e,,c mp huni
<br /> PqKg Me worgc; :et o) rewrns <7rM rim he sprat. f you do n i F,.Fe an account number with the I&I or t tan h"C ap?i`
<br /> . (just1€ns regaC(°i7n t1n, 14e in. cosmyaktris, ppl zise call the BOF at 916-323-9555 or.,v rda tq,the1 B01:?, s'3t the fail.lying addxsst..
<br /> TbalrF of Equaltra it n, ru nmenla; Ise; t_;ht, Pi),, ox 942"S,79, Strcran-m tto, CA 94279.00011
<br /> �' DIET III"II<1;II: US-17 17UNIA y:d°
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<br /> Iden!uy Ord rnstlz<e,,s used l.r tsa ,e-ncr .. r, nr_,a r ,n, n ct "' the I rdenh mid State €ssiaatcid c�sla�t�a utity
<br /> requidructits. yls of.eE, M, any Wdeml or St r..: ,tnrr� .tris: a,quirenioni.
<br /> 1, 11s,GAJL NU11111CIAMON AND BIL ,11443.zt§DIyl;f,ay
<br /> Check t:1NE" BOX for 01c, address ,n:t, ie.l lie used for IXYFH 1:1NW,AND 1111=1,ING Tib"1 I31��5°I1C� bl,
<br /> APTILIGT' ? Uls p SK24 AND IINT11.11113 1 )1 1 AS INDICNITD.
<br /> INS'FRUMION FOR 11113
<br /> The county and jurisdimoui ,,rat t a..t eb,,rt..wd W can he obt ainod, by calling the ,Stare Board �51ts)1r{, IyL, ltaat
<br /> facility S 1 b it tray 3s awgwd , number must, l nencrical and cannot cant a4t any
<br /> a€phat3Ldcal. If the .:ca ,rn-i m U °�et"i., lical� i ..>,,�. .,_? ir;t"rifty .'p.�E,>_,3€.? _<> I€�3re it 2?<x,tl..
<br /> Tr I:1'I' ESWNv S1I3II,IIY (N7 CE p..,CE#_I, PAIMN N I:Ir3,s` 1009T TS'THE FACILITY TO S'1§RH '111F
<br /> J\(XXRACY OFTHE Iy,a D1ZMVa,x0yl. THIS A_,d.If:°.stlll I,'MNN I"1 BE:I"1ta.ICU'NtSI Iy IF JITH DOE Af;I;IIIiNM
<br /> NUMBER IS NUF FI1.1,11) IN. 11M I,a,r.A:_ nlvsll is lurYND'if I'I.,II F"%IIm MIF C'OMI 113.1.tl.N OF°1"1111
<br /> 1A)1 1,AGENCY LJS , 0N Y 'MF )RJ`,,AAJ`H')N ,r .ffX AND c.?I RVIattlf)ING, 1.IF11_, I'OIIIII- 7A"AND
<br /> ASSOCIAT11D 1''01 ,I tIL''.l C,?�.�,t�a'.-��bt.: "aDRI a s.
<br /> III :III OF C,1`aL.II'RIMA
<br /> RII � £ NIS ITTEII- IIISARD
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