verizon1 <br /> Invoice Number Account Number Date Due Page <br /> • <br /> 9758602074 242059101-00004 02/05/16 2 of 32 , <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments and Adjustments <br /> Previous Balance $1,066.78 <br /> Payment—Thank You <br /> Payment Received 12/31/15 —381.78 <br /> Total Payments —$381.78 <br /> Adjustments <br /> Packet Data Roaming for 541-731-7904 on 12/14/15 —550.00 <br /> Packet Data Roaming for 541-731-7904 on 12/14/15 —100.00 <br /> • Intl Trvl 4G Data 250 MB—Acces for 541-731-7904 on 12/14/15 —35.00 <br /> Total Adjustments -$685.00 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> • <br /> Account Monthly Charges <br /> Data SMB 30GB 01/11 —02/10 185.00 <br /> 22%Access Discount 01/11 -02/10 —40.70 <br /> Subtotal $144.30 <br /> Total Account Charges and Credits $144.30 <br /> Correspondence Address: Verizon Wireless Attn: Correspondence Team PO Box 5029 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Account:242059101-00004 CITY OF EUGENE <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 /> ® ❑ <br /> Changing your billing address for Account:242059101-00004 CITY OF EUGENE <br /> Use this space or sign in to My Verizon at vzw.com/changeaddress to change the mailing address where we send your hill.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 Horne 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 /> 0003784-0080702-0000002 of 0000058 C23-IL-5710-03787 <br />