veriz®n✓ <br /> Invoice Number Account Number Date Due Page <br /> e:01 9763743180 371628681-00001 05/08/16 2 of 62 1 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+SEND • <br /> Payments <br /> Previous Balance $546.72 <br /> Payment—Thank You <br /> Payment Received 04/01/16 —546.72 <br /> Total Payments —$546,72 <br /> Balance Forward $.00 <br /> Wratten notations mciudetl with or,on your payment-will-not be reviewed ormfionored7 Please send correspondence to <br /> Verizon Wireless AttniCorrespondence Team PO Box'5029 Wallingford CT 06492 A __ <br /> Automatic Payment Enrollment for Account:371628681-00001 EUGENE-PARKS S OPEN SPACES <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 /> El <br /> • <br /> 0001162 0052422-0000002 of 0000088 C24 <br />