NCC190966_Annual Fee Payment Record_20201113

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/3/2020 7:11:23 AM (Workflow Start Event)
Submit by Selkane, Aziza 11/13/2020 1:55:53 PM (Annual Fee Payment Verification for NCC190966-2020)
* Stimmel Associates, P.A.
• Selkane, Aziza assigned the task to Selkane, Aziza 11/13/2020 1:55 PM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: December 15, 2020 5:00
PM 11/3/2020 7:11 AM

NORTH CAROLINA
Environmental Quvllty
Certificate of NCC190966
Coverage (COC) This is passed fromtheworldlow when the invoice isfiled.
No.*
NC Reference COC NCG01-2019-0966
No.*
Permit Status: Active
Project Name* Vogler Funeral & Cremation Services At Forsyth Memorial Park
Project Address* 3815 Yadkinville Road, Winston Salem, NC
Permittee * SCI North Carolina Funeral Services LLC
County Forsyth
Invoice No.* NCC190966-2020
This is passed fromthe worldlow when the invoice is filed.
Annual Fee * $ 100.00
Invoice Date* 11/3/2020
This is passed fromthe worldlow when the invoice is filed.
Invoice Due Date* 12/3/2020
This is passed fromthe worldlow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment r Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payment 11 /13/2020
Received * Or, if WANBD or NOT FECBV®, this is the date that status is recorded.
Method of Payment* r electronic
r check
f other
Check Number* 31241
Fee Status* PAID
Legally Responsible Michael Decell
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to rrodify problem e-mail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct problem e-mail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 11/13/2020