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Invoice NumberAccount NumberDate DuePage <br />1057115157770247670-0000703/08/122 of 22 <br />Get Minutes UsedGet Data UsedGet Balance <br />#MIN + SEND#DATA + SEND#BAL + SEND <br /> <br />Explanation of Charges <br />Payments <br />Verizon Wireless'Surcharges <br />Previous Balance$229.65 <br />VerizonWireless'Surchargesinclude(i)aRegulatoryCharge <br />Payment - Thank You <br />(whichhelpsdefrayvariousgovernmentchargeswepayincluding <br />governmentnumberadministrationandlicensefees);(ii)a <br />Payment Received 02/07/12-229.65 <br />FederalUniversalServiceCharge(and,ifapplicable,aState <br />Total Payments-$229.65 <br />UniversalServiceCharge)torecoverchargesimposedonusby <br />thegovernmenttosupportuniversalservice;and(iii)an <br />Balance Forward$.00 <br />AdministrativeCharge,whichhelpsdefraycertainexpenseswe <br />incur,includingchargesweorouragentspaylocaltelephone <br />companiesfordeliveringcallsfromourcustomerstotheir <br />customers,feesandassessmentsonournetworkfacilitiesand <br />services,andcostsandchargesassociatedwithnewcellsite <br />construction,localnumberportability,andothergovernment <br />mandates.PleasenotethattheseareVerizonWirelesscharges, <br />nottaxes.Thesecharges,andwhat'sincluded,aresubjectto <br />change from time to time. <br />Taxes, Governmental Surcharges and Fees <br />Includessales,exciseandothertaxesandgovernmental <br />surchargesandfeesthatwearerequiredbylawtobill <br />customers.Thesetaxes,surchargesandfeesmaychangefrom <br />time to time without notice. <br />Late Fee Information <br />A late payment applies for unpaid balances. The charge is the <br />greater of $5 or 1.5% per month, or as permitted by law. <br />Verizon Wireless' Other Charges and Credits <br />Includes charges for products and services, and credits owing. <br />Correspondence Address: Verizon WirelessCustomer Service7000 Central Ave SWAlbuquerque, NM 87121-2096 <br />Automatic Payment Enrollment for Account: 770247670-00007 EUGENE, PARKS & OPEN SPACES <br />Bysigningbelow,youauthorizeVerizonWirelesstoelectronicallydebityourbankaccounteachmonthforthetotalbalancedueonyouraccount.Thecheckyousendwillbeusedto <br />setupAutomaticPayment.Youwillbenotifiedeachmonthofthedateandamountofthedebit10daysinadvanceofthepayment.Iunderstandandaccepttheseterms.This <br />agreementdoesnotalterthetermsofyourexistingCustomerAgreement.IagreethatVerizonWirelessisnotliableforerroneousbillstatementsorincorrectdebitstomyaccount.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 check for this month's payment. <br />Changing your billing address for Account: 770247670-00007 EUGENE, PARKS & OPEN SPACES <br />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 <br />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. <br />PLACE OF PRIMARY USE (PPU) <br />New Address <br />The home or business mailing address indicated to the left <br />City <br />is for the person using the phone(s) and is the person's <br />residential street address or primary business address <br />State/Zip <br /> ___YES ___ NO If "NO" or for multi-line accounts with <br />Daytime PhoneEvening Phone <br />more than one PPU address, please contact our Customer <br />Service Department or visit our website to change the <br />Email <br />user's PPU address. <br /> <br />