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Invoice Number Account Number Date Due Page 1039256306 871628793 -00001 01/08/12 2 of 119 Get Minutes Used Explanation of Charges Get Data Used I Get Balance Verizon Wireless' Surcharges Verizon Wireless' Surcharges include charges to recover or help defray costs of taxes and of governmental charges and fees imposed on us, including a Regulatory Charge (which helps defray costs of various regulatory mandates, including government number administration and license fees) and a Federal Universal Service Charge (and, if applicable, a State Universal Service Charge) to recover costs imposed on us by the government to support universal service, and may include other charges also related to our governmental costs. It also includes an Administrative Charge, which helps defray certain costs we incur, currently including (i) charges we, or our agents, pay local telephone companies for delivering calls from our customers to their customers, (ii) fees and assessments on network facilities and services, and (iii) certain costs and charges associated with proceedings related to new cell site construction. Please note that these are Verizon Wireless charges, not taxes. These charges, and what's included, are subject to change from time to time. Taxes, Governmental Surcharges and Fees Includes sales, excise and other taxes and governmental surcharges and fees that we are required by law to bill customers. These taxes, surcharges and fees may change from time to time without notice. Late Fee Information A late payment applies for unpaid balances. The charge is the greater of $5 or 1.5% per month, or as permitted by law. Verizon Wireless' Other Charges and Credits Includes charges for products and services, and credits owing. Payments Previous Balance Payment — Thank You $1,738.94 Payment Received 12/01/11 — 1,738.94 Total Payments — $1,738.94 Balance Forward $.00 Correspondence Address: Verizon Wireless Customer Service 7000 Central Ave SW Albuquerque, NM 87121 -2096 Automatic Payment Enrollment for Account: 871628793-00001 EUGENE -PW /MAINTENANCE 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 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 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 withdraw your authorization you must call Verizon Wireless. Check with your bank for any charges. 1. Check this box. 2. Sign name in box below, as shown on the bill and date. 3. Return this slip with your check for this month's payment. 0 F 1 0 Changing your billing address for Account: 871628793 -00001 EUGENE -PW /MAINTENANCE Use this space or sign in to My Verizon at www.verizonwireless.com to change the mailing address where we send your bill. If we do not have your most recent email address, provide it below and we'll use it to tell you important information about your Verizon Wireless service. Allow 2 billing cycles for the address change to take effect. New Address City State /Zip Daytime Phone Email Evening Phone PLACE OF PRIMARY USE (PPU) The home or business mailing address indicated to the left is for the person using the phone(s) and is the person's residential street address or primary business address YES NO If "NO" or for multi -line accounts with more than one PPU address, please contact our Customer Service Department or visit our website to change the user's PPU address.