EFTA00201779.pdf

Questions or Changes? • cingular fa :CS tre 0.0 ♦ cingular.com ♦ Toll Free 1 866 293.4634 ♦ 611 from your wireless phone ♦ TTY users • 1 866 429•77TY Date of Invoice: May 16, 2005 SUMMARY OF MONTHLY CHARGES FOR ACCOUNT Previous Payments Late Payment Total Balance Current Monthly Balance Received Charge Adjustments Forward Charges 72.33 -72.33 0.00 14.99 14.99 91.02 Total Your billing cycle began on April 15, 2005 and ended on May 14, 2005 Amount Due Current Monthly Charges 106.01 Monthly Service 59.96 Monthly Usage 17.53 Charges 2.14 Credits 0.00 Government Fees and Taxes 11.39 Total Current Monthly Charges 91.02 TOTAL AMOUNT - Due Upon Receipt 106.01 CINGULAR EXCLUSIVE! OFFICIAL STAR WARS (TM) RINGTONES, GRAPHICS & GAMES ARE NOW AVAILABLE FOR YOUR PHONE. PICK RINGTONES AND MORE FROM STAR WARS EPISODE III: REVENGE OF THE SITH. THE NEW BIG-SCREEN STAR WARS MOVIE IN THEATERS MAY 19. OR MAKE YOUR SELECTION FROM THE 5 PAST STAR WARS BLOCKBUSTERS. TO LOAD YOUR PHONE WITH EXCLUSIVE STAR WARS RINGTONES, GRAPHICS AND GAMES, GO TO MMODE, HIT WHAT'S HOT AND SELECT STAR WARS. Note: => We Print on Front and Back Please Return This Portion With Your Payment. Service # cingular Use of service or payment of this invoice indicates agreement with the General Terms Account la and Conditions for wireless service. Account Name: MARTIN GOLICK 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 required). Total Amount Date Due Amount Due Paid UPON RECEIPT 106.01 MARTIN GOLICK CINGULAR WIRELESS PO BOX 8229 AURORA IL 60572.8229 EFTA00201779 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 Cingular Wireless. This authority will be effective until I notify Cingular 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 cingular.com/myaccount 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: Cingular Wireless appreciates your business and welcomes the opportunity to assist you. Visit our website at cingular.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 0 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. Cingular 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 returned for non-sufficient funds will be charged up to a $30.00 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: Cingular Wireless Next Generation Correspondence P.O. Box 68056 Anaheim Hills. CA 92817-8056 Change of Address Only. Please print address clearly and check the box on the reverse side. Please contact Customer Care to change the Accounf Name and transfer Financial Responsibility. New Billing Address City State Zip Home Phone ( ) Work Phone ( ) If your billing address is NOT your Tax Address, please enter the Tax Address below. (Multi-line accounts should attach a list of each wireless number and the respective Tax Address.) New Tax Address Wireless Number ( City State Zip Recurring Electronic Fund Transfer (REFT) Enrollment. Please read the agreement on the top portion of this page. sign below and check the "REFT Registration' box on the reverse side. Financial Account Holder Signature Date Email Address' ❑ ' I do not wish to receive email notification of special offers available to Cingular Wireless customers. EFTA00201780  Account Number Account Name Date of Invoice cingularthe sing bar MARTIN GOLICK May 16. 2005 Page 3 of 10 ACCOUNT DETAILS SUMMARY OF CURRENT ACTIVITY - CONTINUED Detail of Payments - Thank You! Other Subscriber Charges Item Description Date Applied/Reversed Payment Amount Charge Item Description Charge 1 PAYMENT 05/13/05 12 33 72.33 1 UNIVERSAL CONNECTIVITY CHARGE 2 14. Total of Payments .72.33 Total Other Subscriber Charges 2.14 Current Subscriber Monthly Charoes and Credits Subscriber Government Fees and Taxes Subscriber Number Subscriber Name Charge Item Description Charge 91 02 1 911 SURCHARGE 0.50 Total Current Subscriber Monthly Charges and Credits 91.02 2 SALES TAX 0.32 3 STATE COMM SERVICE TAX 5.33 Total Current Monthly Charges 91.02 4 LOCAL COMM SERVICE TAX 3.12 5 FEDERAL TAX 2.12 Total Subscriber Government Fees and Taxes 11.39 SUMMARY OF CURRENT ACTIVITY TOTAL CURRENT CHARGES FOR 91.02 FOR DETAIL OF CURRENT ACTIVITY Detail of Subscriber Adjustments Item Description Date Applied Charge 1 WARRANTY EXCH PROCESSING CHRG VOICE USAGE FOR 05/03/05 14.99 Total of Subscriber Adjustments 14.99 Number Only Charge Item Date Time Called Calls To Used Rate Description Charge INCOMING 1MIN 500 ANYTIME MINUTES Monthly Service Charges 2 04/14 06 14P DELRAY BCH FL 3MIN S00 ANYTIME MINUTES Item Description Service Dates Charge 4 04/15 0 3 04/1 80 47 6A 48A S 04/1509 02A INCOMING INCOMING NEW YORK NY 1 1MIN MIN 2MIN 500 ANYTIME MINUTES S00 ANYTIME MINUTES S00 ANYTIME MINUTES 1 CALL WAITING 2 TEXT MESSAGING PLAN - 0 MSGS 04/15/05 - 05/14/05 04/15/05 - 05/14/05 0.00 4.99 6 04/15 09 31A 7 04/15 09 37A WPAUABEACH FL WPAUABEACH FL 11 MIN MIN S00 ANYTIME MINUTES S00 ANYTIME MINUTES 3 CALLER ID 04/15/05 - 05/14/05 0.00 8 04/15 0951A INCOMING 4MIN S00 ANYTIME MINUTES 4 VOICEMAIL 04/15/05 - 05114/05 0.00 9 04/15 10.31A 10 04/15 10.35A DELRAY BCH FL INCOMING I1 MIN MIN S00 ANYTIME MINUTES S00 ANYTIME MINUTES 5 DETAIL BILLING 6 COM EOP 1.99EW/3.00INS $4.99 04/15/05 - 05/14/05 04/15/05 - 05/14/05 0.00 4.99 11 0O15 10 43A WPAUABEACH FL 7MIN S00 ANYTIME MINUTES 7 CALL FORWARDING 04/15/05 - 05(14/05 0.00 11 12 04/15 10.50A 13 04/15 02A 14 04/15 11.38A INCOMING WPALMBEACH FL WPALMBEACH FL 2MIN 2MIN 1MIN 500 ANYTIME MINUTES S00 ANYTIME MWUTES S00 ANYTIME MINUTES 8 WORLDCONNECT 9 THREE WAY CAWNG 04/15/05 - 05(14/05 04/15/05 - 05/14/05 0.00 0.00 IS 04/15 16 04/15 11 11 39A 47A INCOMING INCOMING 6MIN 1MIN 500 ANYTIME MINUTES 500 ANYTIME MINUTES 10 $39.99 CHARTER OFFER 04/15/05 - 05/14/05 39.99 11 1000 NIGHT AND WEEKEND MINUTES 04/15/05 - 05/14/05 ---122. 17 04/15 0314P 18 04/16 03:68P WPALMBEACH FL WPALMBEACH FL 11MIN EVT 1 IN 500 ANYTIME MINUTES MESSAGE RETRIEVAL 500 ANYTIME MINUTES Total Monthly Service Charges 59.96 1EVT MESSAGE RETRIEVAL 19 04/16 04:39P WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 20 04/15 04:S0P WPALMBEACH FL INN 500 ANYTIME MINUTES Monthly Usage Charges 21 04/15 06:S0P STUART FL 1MIN 500 ANYTIME MINUTES 22 04/16 11A1A NCOMING 2MIN 1000 NIGHT.WKEND MIN Item Description Only Used Charge 23 04/16 11A1A NCOMING 1 IIt MIN 1000 NIGHT/WKEND MIN 1 500 ANYTIME MINUTES 500 MIN 0.00 EVT CALL WAITING 2 MESSAGE RETRIEVAL 29 EVT 0.00 24 04/16 01:16P NCOMNG MIN 1000 NIGHTMEND MIN 3 1000 NIGHT/WKEND MIN 4 CALL WAITING 313 MIN 10 EVT 0.00 0.00 25 04/16 0158P 26 04/18 11A7A 27 04/18 1221P NCOMING NCOMING PALMBEACH FL II MIN MIN MIN 1000 NIGHTMXEND MIN S00 ANYTIME MINUTES S00 ANYTIME MINUTES 5 100 INCL. MSGS SENT 42 EVT 0.00 28 04/18 12 49P NCOMING I MIN S00 ANYTIME MINUTES 6 411 INFO 1 EVT 1.50 29 04/18 12.S0P 30 04/18 12.54P NCOMING NCOMING 4MIN 1 MIN S00 ANYTIME MINUTES S00 ANYTIME MINUTES 7 INCLUDED MINUTES 8 INTL ROAMING VOICE 258 MIN 7 MIN 0.00 1fi 111 01 31 04:18 39P 32 04:18 03 42P NCOMING NCOMING 1MIN 1MIN S00 ANYTIME MINUTES S00 ANYTIME MINUTES Total Monthly Usage Charges 17.53 33 04/18 05 42P FTLAUDERDL FL 1MIN S00 ANYTIME MINUTES 34 04118 OS 3P FEASTERVL PA 1MIN 500 ANYTIME MINUTES 36 04/18 05 SOP FEASTERVL PA 1MIN 500 ANYTIME MINUTES EFTA00201781 7 angular • unt N mber Account Name MARTIN GOLICK Date of Invoice May 16. 2005 va.sng the bar Page 4 of 10 DETAIL OF CURRENT ACTIVITY - CONTINUED DETAIL OF CURRENT ACTIVITY - CONTINUED VOICE USAGE FOR - Continued VOICE USAGE FOR - Continued Number Onty Charge Number Onty Charge Item Date Time Called Calls To Used Rate Description Charge Item Date Time Called Calls To Used Rate Description Charge 36 04/I 05.53P FEASTERVL PA I MIN 500 ANYTIME MINUTES 99 0423 08 37P INCOMING 1MIN 1000 NIGHT/WKEND MIN 37 04/I 05:54P FEASTERVL PA I MIN DROP CALL CREDIT 100 04123 08 39P WPALMBEACH FL 1MIN 1000 NIGHT/WKEND MIN I MIN 500 ANYTIME MINUTES 101 04/23 08 43P PALM BEACH FL 2MIN 1000 NIGHT/WKEND MIN 38 04/I 06:08P DELRAY BCH FL 1MIN 500 ANYTIME MINUTES 102 04/23 08 5P WPALMBEACH FL 4MIN 1000 NIGHT/WKEND MIN 39 04/1 06:28P FEASTERVL PA 1MIN 500 ANYTIME MINUTES 103 04/23 08 52P INCOMING 1MIN 1000 NIGHT/WKEND MIN 40 04/1 0631P INCOMING I SMIN 500 ANYTIME MINUTES 104 04/23 09 4P INCOMING 1MIN 1000 NIGHT/WKEND MIN 41 04/I 07S2P INCOMING 2MIN 500 ANYTIME MINUTES 106 04/23 09 31P DELRAY BCH FL 1MIN 1000 NIGHT/WKEND MIN 42 04/I 08:10P FTLAUDERDL FL 2MIN 500 ANYTIME MINUTES 106 04/23 0 56P INCOMING 1MIN 1000 NIGHT/WKEND MIN 43 04/I 0822P INCOMING I MIN 500 ANYTIME MINUTES 107 04/23 10 56P INCOMING 1MIN 1000 NIGHTANKEND MIN 44 04/1 08:35P INCOMING 3MIN 500 ANYTIME MINUTES 108 04/24 09 29P INCOMING 1MIN 1000 MGHTANKEND MIN 45 04/1 08:39P INCOMING 1MIN 500 ANYTIME MINUTES 109 04/25 0 OA INCOMING 1MIN 500 ANYTIME MINUTES 46 041 11:19P WPALMBEACH FL IMIN 1000 NIGHTANKEND MIN 110 04/25 03 08P WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 47 04/1 07:12A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 111 04/2503 09P WPALMBEACH FL 1MIN DROP CALL CREDIT 48 07:15A BOYNTONBCH FL 1MIN 500 ANYTIME MINUTES 112 04/25 03 09P INCOMING 1MIN 500 ANYTIME MINUTES 49 001 04/1 07:16A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 1EVT CALL WAITING 50 0411 07:19A WPALMBEACH FL I MIN 500 ANYTIME MINUTES INCOMING 1MIN 500 ANYTIME MINUTES 51 04/1 07:20A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 114 04/25 03 20P 500 ANYTIME MINUTES 52 04/1 07:44A INCOMING MIN 500 ANYTIME MINUTES 115 04/25 04 02P INCOMING 1MIN 500 ANYTIME MINUTES 53 04/1 08:40A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 116 04/25 04 37P INCOMING 3MIN 500 ANYTIME MINUTES 54 04/1 08:43A 55 04/I 08:44A WPALMBEACH WPALMBEACH FL FL 2MIN I P.1IN 500 ANYTIME MINUTES ANYTIME MINUTES 117 04/25 06 30P 118 04/25 08 38P INCOMING INCOMING 2MIN 1MIN 500 ANYTIME MINUTES 500 ANYTIME MINUTES 1EVT MESSAGE RETRIEVAL 119 04/25 08 43P INCOMING 2MIN SOO ANYTIME MINUTES 56041 08:47A WPALMBEACH FL WPALMBEACH FL 1MIN 57 04/I 08:49A 58 04/1 08:51A WPALMBEACH FL INN 2MIN 500 ANYTIME MINUTES ANYTIME MINUTES 500 ANYTIME MINUTES 120 04/25 08 57P 121 04/25 09 COP 122 04/25 09 37P INCOMING INCOMING INCOMING 2MIN 1MIN IMIN 500 ANYTIME MINUTES 1000 NIGHT/WKEND MN 1000 NIGHTANKEND MN 59 04/1 08S6A Toll Free CL I MIN 500 ANYTIME MINUTES 123 04/25 09 59P INCOMING 1MIN 1000 NIGHTANKEND MIN 60 04/1 09.00A Toll Free CL 3MIN 500 ANYTIME MINUTES 124 04/26 06 37A INCOMING IMIN 500 ANYTIME MINUTES 61 04/I 09.C6A WPALMBEACH FL I MIN 500 ANYTIME MINUTES 125 0,126 06 59A INCOMING IMIN 500 ANYTIME MINUTES 62 04/I 09 12A WPALMBEACH FL I MIN 500 ANYTIME MINUTES 126 04/26 07 1OA INCOMING 1MIN 500 ANYTIME MINUTES 63 04/1 09 24A DEERFLDBCH FL 1MIN 500 ANYTIME MINUTES 127 04/26 03 17P INCOMING 1MIN SOO ANYTIME MINUTES 64 04/1 10 42A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 128 04/26 04 23P INCOMING 1MIN 500 ANYTIME MINUTES 65 OW II 43A INCOMING 1MIN 500 ANYTIME MINUTES 129 04/27 12 22P WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 66 OW II 49A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 130 04/27 12 24P WPALMBEACH FL 3MIN SOO ANYTIME MINUTES 67 04/1 0643P INCOMING 1MIN 500 ANYTIME MINUTES 131 04/27 12 32P WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 68 04/2 0618P INCOMING 1MIN 500 ANYTIME MINUTES 132 04/27 12 37P INCOMING 1MIN 500 ANYTIME MINUTES 69 042 061W WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 133 04/27 01 09P WPALMBEACH FL 1MIN SOO ANYTIME MINUTES 70 04/2 07 OSA INCOMING 1MIN 500 ANYTIME MINUTES 134 04/27 01 09P WPALMBEACH FL IMIN 500 ANYTIME MINUTES 71 04/2 10 50A WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 135 04/27 02 26P WPALMBEACH FL 1MIN 500 ANYTIME MINUTES 72 04/2 03 40P 2MIN 500 ANYTIME MINUTES 136 04/27 02 27P Toll Free CL SMIN 500 ANYTIME MINUTES 73 04/2 09 17P STUART FL 74 04/2 09 I7P WPALMBEACH FL FL 1 MIN MIN 1000 NIGHTMKEND MIN 1000 NIGHTANKEND MIN 137 04/27 02 3IP 138 04/27 02 46P WPALMBEACH FL INCOMING SMIN 3MIN 500 ANYTIME MINUTES SOO ANYTIME MINUTES 75 04/2 09 19P 76 04/2 77 04/2 09 30P BOYNTONBCH WPALMBEACH WPALMBEACH FL FL I MIN 3MIN I MIN 1000 NIGHTMEEND MIN 1000 NIGHTM/KEND MIN 1000 NIGHTMKEND MIN 139 04/27 03 28P 140 04/27 03 57P 141 04/27 04 OIP WPAUABEACH FL WPALMBEACH FL WPALMBEACH FL 2MIN 1MIN 1MIN 500 ANYTIME MINUTES 500 ANYTIME MINUTES SOO ANYTIME MINUTES 78 04/2 1021P LAKE WORTH FL 2MIN 1000 NIGHTMKEND MIN 142 0427 08 29P INCOMING 1MIN 500 ANYTIME MINUTES 79 04/2 10S8P WPALMBEACH FL I MIN 1000 NIGHTMKEND MIN 143 04127 08 39P WPALMBEACH FL 2MIN 500 ANYTIME MINUTES 80 04/2 11.00P INCOMING I MIN 1000 NIGHTMKEND MIN 1EVT MESSAGE RETRIEVAL 81 4/2 1 01P INCOMING SMIN 1000 NIGHTANKEND MIN 144 01/27 09:22P INCOMING 1MIN 1000 NIGHTANKEND MIN 82 04/2 . INCOMING 2MIN 1000 NIGHTANKEND MIN 145 04/27 09:25P WPAUABEACH FL 1MIN 1000 NIGHT/WKEND MIN 83 04/22 07 01A 84 0422 09 24A 85 04/22 09 26A INCOMING WPALMBEACH FL WPALMBEACH FL 1MIN 1MIN 1MIN 500 ANYTIME MINUTES 500 ANYTIME MINUTES 500 ANYTIME MINUTES 146 04/27 11:05P 147 04/27 t 1:08P WPALMBEACH FL INCOMING