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VerIZQAwireless <br /> Invoice Number Account Number Date Due Page <br /> 9718360460 871628793 -00005 02/08/14 2 of 15 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN + SEND #DATA + SEND #BAL + SEND <br /> Explanation of Charges Payments <br /> - Verizon Wireless' Surcharges Previous Balance $84.44 <br /> - Verizon Wireless' Surcharges include (i) a Regulatory Charge <br /> (which helps defray various government charges we pay including Payment — Thank You <br /> - government number administration and license fees); (ii) a Payment Received 01/06/14 — 84.44 <br /> C Federal Universal Service Charge (and, if applicable, a State <br /> Universal Service Charge) to recover charges imposed on us by Total Payments — $84.44 <br /> - the government to support universal service; and (iii) an Balance Forward $.00 <br /> Administrative Charge, which helps defray certain expenses we <br /> incur, including charges we or our agents pay local telephone <br /> companies for delivering calls from our customers to their <br /> customers, fees and assessments on our network facilities and Account Charges and Credits <br /> - services, and costs and charges associated with proceedings <br /> - related to cell sites, local number portability, and other Account Monthly Charges <br /> - government mandates. Please note that these are Verizon <br /> - Wireless charges, not taxes. These charges, and what's included, Share Data 8GB 01/14 — 02/13 50.00 <br /> - are subject to change from time to time. 22% Access Discount 01/14 — 02/13 —11.00 <br /> Subtotal $39.00 <br /> - Taxes, Governmental Surcharges and Fees <br /> Includes sales, excise and other taxes and governmental <br /> surcharges and fees that we are required by law to bill Total Account Charges and Credits $39.00 <br /> customers. These taxes, surcharges and tees may change from <br /> time to time without notice. <br /> Understanding Your Prorated (partial month) Charges <br /> Prorated charges occur when you add new service, or make a <br /> change to your existing service, in the middle of your bill cycle. <br /> Prorated charges are calculated by determining the daily charge, <br /> and then by multiplying the daily charge by the number of days <br /> the service was used. <br /> If a plan change is effective as of a date during the bill cycle, your <br /> proration will include a credit for unused days on the old plan, <br /> and a charge for the days used on your new plan. <br /> Correspondence Address: Verizon Wireless Attn: Correspondence Team PO Box 5029 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Account: 871628793 -00005 EUGENE-PW/MAINTENANCE <br /> By signing below, you authorize Verizon Wireless to electronically debit your bank account each month for the total balance due on your account. The check you send will be used to <br /> setup Automatic Payment. You will be notified each month of the date and amount of the debit 10 days in advance of the payment. I understand and accept these terms. This <br /> agreement does not alter the terms of your existing Customer Agreement. I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debits to my account. To <br /> withdraw your authorization you must call Verizon Wireless. Check with your bank for any charges. <br /> 1. Check this box. 2. Sign name in box below, as shown on the bill and date. 3. Return this slip with your payment. Do not send a voided check. <br /> • •L1I 1 ■ <br /> Changing your billing address for Account: 871628793 -00005 EUGENE-PW/MAINTENANCE <br /> Use this space or sign in to My Verizon at vzw.com /changeaddress to change the mailing address where we send your bill. If we do not have your most recent email address, provide it <br /> below and we'll use it to tell you important information about your Verizon Wireless service. Allow 2 billing cycles for the address change to take effect. <br /> New Address Confirming or changing your service address <br /> For each of your mobile numbers, in order to bill taxes and <br /> City _ surcharges correctly we need a service address - which is a <br /> street address (not a PO Box) that is the home or primary <br /> State/Zip business address of the person who uses that number. To <br /> Work Phone Home Phone confirm or change the service address for any of your mobile <br /> numbers, sign in to My Verizon at vzw.com/serviceaddress <br /> Email <br /> Order #: 5713 Copy #: 05 <br /> Control #:20000553 - 00004625 <br />