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verizon <br /> Invoice Number Account Number Date Due Page <br /> 9794377722 971640668-00001 11/05/17 2 of 6 <br /> Get Minutes Used Get Data Used <br /> #MIN+SEND Get Balance <br /> #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $203.58 <br /> Payment—Thank You <br /> Payment Received 09/22/17 <br /> Total Payments —203.58 <br /> -$203.58 <br /> Balance Forward $.0O <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 2.91089 Columbia, SC 29229 <br /> automatic Payment Enrollment for Account.971640668-00001 CITY OF EUGENE-5MB SPRINKLERS <br /> 3y 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 /> setuomm nications electronircaly.I understand and accept these terms.This agreement does not alter <br /> nth of the date and amount of the it 10 the terms d of your existing Customer Agreement.I agree <br /> fable for erroneous bill statements or incorrect debits to payment.You agree to receive all Auto Pay related <br /> my account.To withdraw your authorization you must call Verizon Wireless.Check with your bnorhanVerizon <br /> cha gesireless is not <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 /> • 1111111111111111111111111111.111111111111111111111.0 <br /> 1111 <br /> 0018377-0068507-0000002 of 0000008-C11-LT-6610-18395 <br />