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veru®n✓ <br /> Invoice Number Account Number Date Due Page <br /> ( 9758724415 . -872298827-00001 02/05/16 - 2 of 4 's <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+SEND <br /> • Payments <br /> Previous Balance • $546.67 <br /> Payments—Thank You <br /> Payment Received 12/21/15 —281.12 <br /> Payment Received 12/23/15 —265.55 <br /> Total Payments —$546.67 <br /> Balance Forward $.00 <br /> • <br /> Correspondence Address Verizon Wireless Attn Correspondence Team PO.Box:5029 Wallingford,CT 06492 ..! <br /> Automatic Payment Enrollment for Account:872298827-00001 CITY OF EUGENE-SPRINKLERS <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 /> Changing your billing address for Account:872298827-00001 CITY OF EUGENE-SPRINKLERS <br /> Use this space or sign in to My Verizon at vzw.comlchangeaddress 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 into My Vedzon at vzw.corn/serviceaddress. <br /> Email <br /> 0024342-0086314-0000002 of 00000tH-C11-LT:571034366 <br />