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verizon <br /> Invoice Number Account Number Date Due Page <br /> 9767031188 371628681-00001 Past Due 2 of 68 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $625.11 <br /> No Payment Received <br /> _ Total Payments $.00 <br /> Balance Forward Due Immediately $625.11 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Previous Plan <br /> MORE EVERY UNL TLK&TXT 12GB 05/19—05/31 46.13 <br /> $110.00 per month/13 days on plan <br /> 22%Access Discount 05/19—05/31 —10.15 <br /> New Plan <br /> SMB UNL Talk&TXT 30GB 06/01 —06/13 94.35 <br /> $225.00 per month/13 days on new plan <br /> 22%Access Discount 06/01 —06/13 —20.76 <br /> Month in Advance <br /> SMB UNL Talk&TXT 30GB 06/14—07/13 225.00 <br /> 22%Access Discount 06/14—07/13 —49.50 <br /> These are the normal monthly charges billed in advance. <br /> Subtotal $285.07 <br /> Total Account Charges and Credits $285.07 <br /> Written notations included with or on your payment will not be reviewed or honored. Please send correspondence to: <br /> Verizon Wireless Attn:Correspondence Team PO Box 5029 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Account:371628681-00001 EUGENE-PARKS&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 /> • L1 <br /> ■ <br /> 0001115-0050118-0000002 of 0000086-C24-13K-6213-01116 <br />