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r• <br /> verizon <br /> Invoice Number Account Number Date Due Page <br /> 9783892603 371628681-00002 05/08/17 2 of 6 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+. <br /> Payments <br /> Previous Balance $.00 <br /> No Payment Received <br /> Total Payments $.00 <br /> Balance Forward $,00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Previous Plan <br /> SMB UNL Talk&TXT 30GB 04/06—04/12 50.81 <br /> $225.00 per month/7 days on plan <br /> 22%Access Discount 04/06—04/12 —11.18 <br /> Subtotal $39.63 <br /> Total Account Charges and Credits $39.63 <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 P.O. Box 291089 Columbia, SC 29229 <br /> Automatic Payment Enrollment for Account:371628681-00002 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 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 /> ULI <br /> ■ <br /> I <br /> 0006677-0026514-0000002 of 0000006-C11-LT-6013-06633 <br />