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veriz®ni • Invoice Number Account Number Date Due Page <br /> 9757198053 371628681-00001 01/08/16 2 of 74 <br /> Get Minutes Used Get Data Used Get Balance <br /> kMIN'+'SEND"" `41DATA+SEND'-- ' irBAL+SEND`,ya` <br /> • Payments <br /> Previous Balance $1,419.92 <br /> Payments—Thank You <br /> Payment Received 11/19/15 —1,095.95 <br /> Payment Received 12/04/15 —323.97 <br /> Total Payments —$1,419.92 <br /> Balance Forward $.00 <br /> • <br /> • <br /> Correspondence Address Verizon Wireless Attn Correspondence Team PO Box 5029 Wallingford CT 064921 '{ � <br /> Automatic Payment Enrollment for Account:371628681-00001 EUGENE-PARKS&OPEN SPACES <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 he 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 /> Changing your billing address for Account:371628681-00001 EUGENE-PARKS&OPEN SPACES <br /> Use this space or sign in to My Verizon at vzw.con✓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 well 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 /> Statelzip 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 /> 0001336 0060112.000002 of 0000098-04-BK 6813.01337 <br />