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verizonInvoice Number Account Number Date Due Page <br /> 9772012102 871628793-00001 10/08/16 2 of 51 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND t SENA, . ... <br /> Payments <br /> Previous Balance $571.15 <br /> Payment—Thank You <br /> Payment Received 08/25/16 —571.15 <br /> Total Payments —$571.15 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> MORE EVERY UNL TLK&TXT 10GB 09/14— 10/13 100.00 <br /> 22%Access Discount 09/14—10/13 —22.00 <br /> Subtotal $78.00 <br /> Total Account Charges and Credits $78.00 <br /> • <br /> � :^a <br /> C♦_tet. <br /> Written notations included with or on your payment will not be reviewed or honored. Please send correspondence to: <br /> Verizon Wireless Attn: Correspondence Team PO Box 5029 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Accou ::871628793-00001 EUGENE-PW/MAINTENANCE <br /> By signing below,you authorize Verizon Wireless to electronically debit your bank account each month for the total balance due on your account.The check you send will be used to <br /> setup Automatic Payment. You will be notified each month of the date and amount of the debit 10 days in advance of the payment. I understand and accept these terms. This <br /> agreement does not alter the terms of your existing Customer Agreement.I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debits to my account.To <br /> withdraw your authorization you must call Verizon Wireless.Check with your bank for any charges. <br /> 1.Check this box. 2.Sign name in box below,as shown on the bill and date. 3.Return this slip with your payment.Do not send a voided check. <br /> ■ ❑ ■ <br /> OOO)00)))))4°) 000UOU_'of UUOOOT't_?.7$K-6513-01099 <br />