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verizon <br /> ?Ago <br /> Invoice Number Account Number Date Due Page <br /> 9776458318 542011189-00001 12/30/16 2 of 15 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $949.81 <br /> Payment—Thank You <br /> Payment Received 11/14/16 —949.81 <br /> Total Payments —$949.81 <br /> Balance Forward $.00 <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 50.29 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Account:542011189-00001 CITY OF EUGENE <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 /> unt of the <br /> agreement Automatic <br /> not alterlthe termslof be <br /> rtified each month of the date and existing Customer Agreement.I agreeothat Verizondebit 10 Wirelesstlisys notnadvance of the liable for erroneouspbill statementsent. I roriincand orrect 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 /> LJI <br /> I ■ <br /> omx)(x6 0082530-0000002 of 0000016-C12-RG-6804-09075 <br />