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verizon✓ <br /> Invoice Number Account Number Date Due Page <br /> 9763228142 .542011189-00001.. 04/29/16 2 of 15 : ' <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $895.88 <br /> Payment-Thank You <br /> Payment Received 04/01/16 -895.88 <br /> Total Payments -$895.88 <br /> Balance Forward $.00 <br /> Written notations inclutledtivith or on your payment will nofbe reviewed orhonored Please send-Correspondence to`� <br /> Verizon Wireless Attn: Correspondence Team PO Box50291Wallingtord CI 06492 <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 he 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 tor 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 /> 0010947.0097647-0000002 of 0000016C122G-6004-10957 <br />