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verizonl/ <br /> Invoice Number Account Number Date Due Page <br /> 9768436098 242059101-00003 08/05/16 2 of 31 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND <br /> #BAL+SEND <br /> Payments <br /> — <br /> Previous Balance $394.80 <br /> Payment-Thank You <br /> Payment Received 07/06/16 -394.80 <br /> Total Payments -$394.80 <br /> Balance Forward $.00 <br /> — Account Charges and Credits <br /> Account Monthly Charges <br /> _ Data SMB 30G6 <br /> 07/11 -08/10 185.00 <br /> �• 22%Access Discount 07/11 -08/10 -40.70 <br /> Subtotal $144.30 <br /> Total Account Charges and Credits $144.30 <br /> Written notations inctadedvvlth or on your payment will not be revied or honored.Please send correspondence to: <br /> Verizon Wireless Attn:Correspondence Team PO Box 5029 Wallingford,CT 06492 <br /> Automatic Payment Enrollment for Account:242059101-00003 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 /> aLli <br /> I <br /> ■ <br /> 0003040 0000530-0000002 of 0000058-C2 3-FL-6310-03043 <br />