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verizon • . <br /> Invoice Number Account Number Date Due Page <br /> 9778657622 371628681-00001 02/08/17 2 of 59 <br /> Get Minutes Used —T-- - <br /> Get Data Used <br /> #MIN+SEND Get Balance <br /> #DATA+SEND #BAL+SEND - <br /> Payments <br /> Previous Balance <br /> Payment–Thank You $605.82 <br /> Payment Received 12/23/16 <br /> Total Payments –605.82 <br /> –$605.82 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> SMB UNL Talk&TXT 30GB 01/14–02/13 225.00 <br /> 22%Access Discount 01/14–02/13 –49.50 <br /> Subtotal <br /> $175.50 <br /> Total Account Charges and Credits <br /> $175.50 <br /> 1 <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 Pa ment Enrollment for Account:371628681-00001 EUGENE-PARKS&OPEN SPACES <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 /> urli — <br /> ■ <br /> 0001083-0048630-0000002 of 0000078-C24_81(-5713-01084 <br />