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verizon" <br /> Invoice Number Account Number Date Due Page <br /> 9759950486 542011189-00001 02/28/16„2 of 15 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN #DATA+,SEND #BAL+SEND <br /> Payments <br /> Previous Balance $854.87 <br /> Payment-Thank You <br /> Payment Received 02/04/16 -854.87 <br /> Total Payments -$854.87 <br /> Balance Forward $.00 <br /> "-` 7 Writtennotations innclt7dedTWith or on your payment wiltnolbe reviewed'or'honored.-Please'send correspondence to ` _.._....._i <br /> `•' 'Vernon Wireless Attn: Correspondence Team PO Box 5029 Wallingford CT 06492 • : . I <br /> Automatic Payment Enrollment for Account:542011189-00001 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 terns. 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 /> III CI 1111 <br /> 15)12472-0110]02-0000002 of 000001E-C12.0G5804.12134 <br />