EFTA01310858.pdf

Questions or Changes? • athwetess.com AT&T Wireless • Toll Free 1 866 293-4634 • 611 from your wireless phone • TT' users 1 866 4•AWS•TTY Date of Invoice: November 14, 2004 SUMMARY OF MONTHLY CHARGES FOR ACCOUNT Previous Payments Late Payment Account Balance Balance Received Charge Adjustments Forward -24.33 -65.91 0.00 0.00 -90.24 47.60 Total Your billing cycle began on October 12, 2004 and ended on November 11, 2004 Credit Amount Current Monthly Charges -42.64 Subscriber Adjustments 0.00 Monthly Service 0.00 Monthly Usage 15.30 Charges 20.37 Credits 0.00 Taxes. Surcharges & Regulatory Fees 11.93 Total Current Monthly Charges DUE UPON RECEIPT 47.60 TOTAL CREDIT AMOUNT 42.64 CREDIT BALANCE - DO NOT PAY Note: => We Print on AT&T WIRELESS APPRECIATES YOUR BUSINESS Front and Back Please Return This Ponion With Your Payment. Use of service or payment of Ors invoice indicates agreement AT&T Wireless vnih the General Terms and Conditions for wireless service. Account Name: Yes. I want to enroll in REFT and have my monthly payments Check here for change automatically deducted from the account on my enclosed check of address (see reverse). (see reverse signature mired). THIS IS NOT AN INVOICE - DO NOT PAY AT&T WIRELESS PO BOX 8229 AURORA IL 60572-8229 000000000000000000003522422830000000042643 SDNY_GM_00336054 CONFIDENTIAL EFTA_00208758 EFTA01310858 Recurring Electronic Fund Transfer (REFT): To enroll: sign below. check the REFT box on the reverse side and remit with this month's payment. Keep paying your bill until your statement indicates "Do Not Pay'. REFT Agreement: I authorize my financial institution to deduct the amount of my monthly wireless phone bill from the account associated with the enclosed check and remit payment to AT&T Wireless. This authority will be effective until I notify AT&T Wireless to terminate it. I agree that I may be assessed a service charge (up to $20) or late fee or both if a payment is returned by my bank. For more information visit attwireless.comiocs or call 1 866 293-4634. Please keep a copy of the form below and this REFT Agreement for your records or retain a copy of the blank form from next month's invoice. Questions? We can help: AT&T Wireless appreciates your business and welcomes the opportunity to assist you. As part of our commitment to you, we are always adding new calling plans and promotions to match your individual needs. Visit our website at attwireless.com or contact Customer Care by dialing 611 from your wireless phone or 1 866 293-4634. tSabias que tambien ofrecemos servicio al cliente en tu idioma? Marca 611 desde tu telefono inalambrico et 1 866 293 4634 desde cualquier telefono y oprime el'. Driving Wireless Safety: Your wireless phone gives you the freedom and flexibility to stay in touch when you travel. but don't let a phone call distract you from driving safely. Use hands-free device if allowed or required by law. Call Carefully. Arrive Safely. AT&T Wireless Processing Fees: Accounts suspended for non-payment will be subject to a $25 reactivation fee per line and may be assessed a security deposit prior to reinstatement. Checks retumed for non-sufficient funds will be charged up to a $20.00 fee. Local Tax: Local taxes are based on local government boundaries, the address information you provide for your account and/or your wireless telephone number. Please review the local tax charges on your bill. If you believe there is an error in the local tax charge. please contact us immediately at 1 866 293-4634. Please note that some local or state laws may require you to follow special procedures when notifying us about a local tax dispute. You may also use the form below to notify us of any change to your taxing address. Thank you for your cooperation. Early Termination Fee (ETF): If you cancel service before your contract end date (including if you switch your wireless number to another carrier). you will be charged an Early Termination Fee of up to $200. Please Send Correspondence To: AT&T Wireless Next Generation Correspondence P.O. Box 68056 Anaheim Hills. CA 92817-8056 0.0000084868 Change of Address Only. Please print address clearly and check the box on the reverse side. Please contact Customer Care to change the Account Name and transfer Financial Respcoseity. New Billing Address City State Zip Home Phone ( Work Phone ( II your billing address is NOT your Tax Address', please enter the Tax Address below. (Multi-ire accounts should attach a 1st of each wireless number and the respective Tax Address.) New Tax Address* Wireless Number ( ) City State Zip 'Under Federal laws. your Tax Address must be: your primary place of use. your residential or business address. and located within AT&T Wireless 0 licensed service area. Non-business customers on AT&T Digital One Rate. Regional Advantage or Shared Advantage plans must use their residential address as their tax address. Recurring Electronic Fund Transfer (REFT) Enrollment. Please read the agreement on the top portion of Mitt page. sign begow and check the "REFT Registration" box on the reverse side. 61.36 Financial Account Holder Signature Date Email Address' ' I do not wish to receive email notification of special offers available to AT&T Wireless customers. SDNY_GM_00336055 CONFIDENTIAL EFTA_00208759 EFTA01310859  Date of Invoice a November 14. 2004 AT&T Wireless Page 3 of 6 ACCOUNT DETAILS SUMMARY OF CURRENT ACTIVITY - CONTINUED Detail of Payments - Thank You! Monthly Usage Charges Item Description Date Applied(Reversed Payment Amount Charge Item Description Only Used Charge 1 PAYMENT 11104104 .65.91 6591 1 UNLIMITED NIWKND MIN 466 MIN 0.00 Total of Payments -65.91 2 AIRTIME MINUTES 170 MIN 15.30 3 MESSAGE RETRIEVAL 11 EVT 0.00 Detail of Other Account Charges 4 CALL WAITING 3 EVT 0 00 Item Description Charge Total Monthly Usage Charges 15.30 1 30 DAY BALANCE EXPIRATION 20 37 Total of Other Account Charges 20.37 TOTAL CHARGES FOR (561)308-0282 15.30 Detail of Account Taxes, Surcharges and Regulatory Fees DETAIL OF CURRENT ACTIVITY Item Description Charge 1 UNIVERSAL CONNECTIVITY CHARGE 1.49 2 FEDERAL TAX 1.68 3 COUNTY 911 TAX 0.50 4 LOCAL COMM SERVICE TAX 3.17 5 STATE COMM SERVICE TAX 5.09 Total Account Taxes. Surcharges and Regulatory Fees 11.93 Current Subscriber Month! Char es and Credits Charge 15.30 oa urrenSubscriber on y arges an re f s 15.30 Total Current Monthly Charges 47.60 SUMMARY OF CURRENT ACTIVITY Monthly Service Charges Item Description Service Dates Charge 1 CALL WAITING 10/12/04 - 11/11/04 0.00 2 CALLER ID 10/12/04 - 11/11/04 0.00 3 GO PHONE 553.98 REPLENISHMENT 10'12/04 - 11111/04 0.00 4 THREE WAY CALLING 10'12/04 - 11111/04 0.00 5 GO PHONE UNLIMITED NIGHTS AND WEEKENDS 10'12104 - 11/11104 0.00 6 DETAIL BILLING 10'12104 - 11/11104 0.00 Total Monthly Service Charges 0.00 SDNY_GM_00336056 CONFIDENTIAL EFTA_00208760 EFTA01310860  Date of Invoice November 14. 2004 a AT&T Wireless Page 4 of 6 DETAIL OF CURRENT ACTIVITY - CONTINUED DETAIL OF CURRENT ACTIVITY - CONTINUED SDNY_GM_00336057 CONFIDENTIAL EFTA_00208761 EFTA01310861  Date of Invoice November 14, 2004 AT&T Wireless Page 5 of 6 DETAIL OF CURRENT ACTIVITY - CONTINUED DETAIL OF CURRENT ACTIVITY - CONTINUED I i SDNY_GM_00336058 CONFIDENTIAL EFTA_00208762 EFTA01310862  Date of Invoice November 14. 2004 AT&T Wireless Page 6 of 6 - THIS SPACE INTENTIONALLY LEFT BLANK "' - THIS SPACE INTENTIONALLY LEFT BLANK "' SDNY_GM_00336059 CONFIDENTIAL EFTA_00208763 EFTA01310863