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verizon • 4: <br /> Invoice Number Account Number Date Due Page <br />• <br /> 9787234299 242059101-00002 07/05/17 2 of 31 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $425.20 <br /> Payment—Thank You <br /> Payment Received 05/23/17 —425.20 <br /> Total Payments —$425.20 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> SMB UNL Talk&TXT 50GB 06/11 —07/10 375.00 <br /> 22%Access Discount 06/11 —07/10 —82.50 <br /> Subtotal $292.50 <br /> Total Account Charges and Credits $292.50 <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 Enrollmer,t for Account:242059101-00002 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 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 /> 0002144 0043532 0000002 of 0000056 C23 FL 6210.02146 <br />