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verizonNtrk'14: <br /> Invoice Number Account Nu } <br /> tuber Date Due Page <br /> 9778416091 242059101-00002 02/05/17 2 of 32 <br /> Get Minutes Used Get Data Used <br /> #MIN+SEND I Get Balance <br /> #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $394.80 <br /> Payment—Thank You <br /> Payment Received 12/22/16 —394.80 <br /> Total Payments — —$394.80 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Previous Plan <br /> Data SMB 30GB Refund 12/11 —01/10 —185.00 <br /> $185.00 per month/full month refunded <br /> 22%Access Discount—Reversal 12/11 —01/10 40.70 <br /> New Plan <br /> Data SMB 40GB 12/11 —01/10 260.00 <br /> $260.00 per month/full month on new plan <br /> 22%Access Discount 12/11 —01/10 —57.20 <br /> Month in Advance <br /> Data SMB 40GB 01/11 —02/10 260.00 <br /> 22%Access Discount 01/11 —02/10 —57.20 <br /> These are the normal monthly charges billed in advance. <br /> Subtotal <br /> $261.30 <br /> Total Account Charges and Credits <br /> $261.30 <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 Account:2420.59101-00002 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 noted 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 /> III ❑ <br /> ■ <br /> 0003212-0068010-0000002 or 0000058-C23-FL-5710-03215 <br />