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verizon <br /> Invoice Number Account Number <br /> Date Due Page <br /> 9783784146 971640668-00001 05/05/17 2 of 7 <br /> Get Minutes Used <br /> Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND <br /> #BAL+SEND <br /> Payments <br /> Previous Balance <br /> Payment—Thank You $203.60 <br /> Payment Received 03/22/1.7 <br /> —203.60 <br /> Total Payments <br /> —$203.60 <br /> Balance Forward <br /> $.00 <br /> Written notations included with or on your payment will not be reviewed or honored. Please send correspondence to: <br /> Verizon Wireless Attn: C o_rrespondence Tea_m P.O. Box 291089 Columbia, SC 29229 <br /> Automatic Pa ent Enrollment for Account:971640668-00001 <br /> SP <br /> RS <br /> By signing below,you authorize Verizon Wireless to electronically debit Iyour bank account TY OF EUGENE- each Rmon month for the total balance due on your account.The check you send will be used to <br /> setuagreement does not alter the terms of your existing Customer Agreement.nag agree that Verizond amount of the debit 10 Wi elesstlis not liable for erroneous bill statements <br /> withdraw your authorization you must call Verizon Wireless.Check with your bank for any charges. payment. I understand and accept these terms. This <br /> 1.Check this box. 2.Sign name in box below,as shown on the bill and date. or incorrect debits to my account.To <br /> 3.Return this slip with your payment.Do not send a voided check. <br /> IL] <br /> ■ <br /> 0017288-0064833-0000002 of 0000010-Cl14T-6010-17305 <br />