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verizonn <br /> Invoice Number Account Number Date Due Page N <br /> 9770083560 242091010y, 2 09/05/16 2 of 32 <br /> Get Minutes Used Get Data Used <br /> #MIN+SEND Get Balance <br /> #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $403.49 <br /> Payment—Thank You <br /> Payment Received 08/05/16 <br /> —403.49 <br /> Total Payments —$403.49 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Data SMB 30G6 08/11 —09/10 185.00 <br /> 22%Access Discount 08/11 —09/10 —40.70 <br /> Subtotal <br /> $144.30 <br /> Account Usage Charges <br /> Data Over Allowance—GB <br /> Subtotal 465.00 <br /> $465.00 <br /> Total Account Charges and Credits <br /> $609.30 <br /> Written notations Included with or on your payment will notbe 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:242059101 <br /> By signing below,you authorize Verizon Wireless to electronically-0debit t your baOF nk accouENE nt eac month for the total balance due on your account.The check you send will be <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. <br /> 3.Return this slip with your payment.Do not send a voided check. <br /> ■ ❑ I <br /> I ■ <br /> 0003079-0065061-0000002 of 0000058-C23-FL-6410-03082 <br />