Ve'nzatwireless <br /> Invoice Number Account Number Date Due Page <br /> 9750447926 542058966-00001 09/05/15 2 o 16 <br /> Get Minutes Used Get Data Used <br /> #MIN+SEND Get Balance <br /> #DATA+SEND #BAL+SEND <br /> Explanation of Charges Payments <br /> Verizon Wireless'Surcharges <br /> Verizon Wireless' Surcharges include (i) a Regulatory Charge Previous Balance $131.40 <br /> (which helps defray various government charges we pay including Payment—Thank You <br /> �= <br /> government number administration and license fees); (ii) a <br /> Payment Received 07/30/15 —131.40 <br /> Federal Universal Service Charge (and, if applicable, a State <br /> Universal Service Charge)to recover charges imposed on us by Total Payments <br /> the government to support universal service; and (iii) an —$131.40 <br /> — Administrative Charge, which helps defray certain expenses we Balance Forward $,00 <br /> . incur, including:charges we, or our agents, pay local telephone <br /> companies for delivering calls from our customers to their <br /> zir..m customers; fees and assessments on our network facilities and Account Charges and Credits <br /> services; property taxes; and the costs we incur responding to <br /> regulatory obligations. Please note that these are Verizon Account Monthly Charges <br /> •••.m. Wireless charges,not taxes.These charges,and what's included, <br /> are subject to change from time to time. MORE EVERYTHING DATA 6G6 <br /> 08/11 —09/10 40.00 <br /> 22%Access Discount 08/11 —09/10 —8.80 <br /> Taxes,Governmental Surcharges and Fees Subtotal <br /> Includes sales, excise and other taxes and governmental $31.20 <br /> surcharges and fees that we are required by law to bill <br /> customers. These taxes, surcharges and fees may change from Total Account Charges and Credits <br /> time to time without notice. $31.20 <br /> Late Fee Information <br /> A late payment applies for unpaid balances.The charge is the <br /> greater of$5 or 1.5%per month,or as permitted by law. <br /> Verizon Wireless'Other Charges and Credits <br /> Includes charges for products and services,and credits owing. <br /> Correspondence Address.Verizon Wireless Attn.Correspondence Team PO Box 5029 Wallingford,CT 06492 <br /> Automatic Payment Enrollment for Account:542058966-00001 CITY OF EUGENE PWM/POS <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 Wreless is not liable for erroneous bill statements or incorrect debits to my account.To <br /> withdraw your authorization you must call Verizon Wreless.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 /> RE] I <br /> I ■ <br /> Changing your billing address for Account:542058966-00001 CITY OF EUGENE PWM/POS <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 /> City For each of your mobile numbers,in order to bill taxes and <br /> surcharges correctly we need a service address-which is a <br /> State/Zipstreet address(not a PO Box)that is the home or primary <br /> business address of the person who uses that number.To <br /> confirm or change the service address for any of your mobile <br /> Work Phone Home Phone <br /> Email numbers,sign in to My Verizon at vzw.com/serviceaddress. <br /> 0018677 0160362-0000002 of 0000028-C22-RG-6410-18695 <br />