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verizon <br /> Invoice Number Account Number Date Due Page <br /> r t 9763508599 242059101-00001 05/05/16 2 of 68 • r4 " ' <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $968.37 <br /> Payment–Thank You <br /> Payment Received 03/31/16 –968.37 <br /> Total Payments –$968.37 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> SMB UNL Talk&TXT 30GB 04/11 –05/10 225.00 <br /> 22%Access Discount 04/11 -05/10 –49.50 <br /> Subtotal $175.50 <br /> Total Account Charges and Credits $175.50 <br /> (-'----Wrltten notations included with or on your paymentwirtiot-be�evlewetl or honored Please send correspondence to <br /> • Verizon Wireless Attn: Correspondence Team PO Boxr5029:Wallingford, CL06492 <br /> Automatic Payment Enrollment for Account:242059101-00001 CITY OF EUGENE PWM/POS <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 /> 0001328 00591240000002 of 00000)8124-BK-6010-01329 <br />