verizon" <br /> Invoice Number Account Number Date Due Page <br /> 9768559387 87228827-00001 Past Due 2 of 4 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $269.68 <br /> No Payment Received <br /> Total Payments $.00 <br /> Balance Forward Due Immediately $269.68 <br /> itten notations included with or on your payment will not bare or hOnored.Pietist sand correspondence to: <br /> Verizon-Wireless Attn:Correspondence Team Pd Bei€5029,1Naltingfere,CT 06492 <br /> Automatic Payment Enrollment for Account:872298827-00001 CITY OF EUGENE-1 MB SPRINKLERS <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 E] <br /> 0015775 0056237-0000002 of 0000006-C11 LT-6310-15790 <br />