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verizon p.;+a <br /> Invoice Number Account Number Date Due Page <br /> 9795698401 542011189-00001 11/29/17 2 of 14 <br /> Get Minutes Used I Get Data Used <br /> #MIN+SEND Get Balance <br /> #DATA+SEND #BAI. +SEND <br /> Payments <br /> Previous Balance $993.96 <br /> Payment—Thank You <br /> Payment Received 10/19/17 —993.96 <br /> Total Payments —$993.96 <br /> Balance Forward $.00 <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;542011189-00001 CITY OF EUGENE <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. You agree to receive all Auto Pay related <br /> communications electronically.I understand and accept these terms.This agreement does not alter the terms of your existing Customer Agreement.I agree that Verizon Wireless is not <br /> liable for erroneous bill statements or incorrect debits to my account.To 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 /> lull <br /> I ■ <br /> 0(x18119-0064201 0000007 of 0000016 Cl?-RG-6704-08127 <br />