Bill Pay First Name: Last Name: Billing Address:City: State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY Zip Code: Phone Number: E-Mail: Invoice Number: Recurring? Yes Frequently Monthly Recurring Amount: Amount: Bill Pay Services Service is offered on a monthly basis for a term that begins on the date that GTI activates your Service and ends on the last day of the first full calendar month after such activation date. The term of this Agreement shall automatically renew for an unlimited number of successive monthly periods thereafter, unless you deliver written notice of non-renewal at least ten (10) days before the end of the then-current monthly term. You are purchasing the Service for full monthly terms, meaning that if you attempt to disconnect Service prior to the end of a monthly term, you will be responsible for the full months charges to the end of such monthly term, including, without limitation, unbilled charges, plus a disconnection fee, if applicable, all of which will immediately become due and payable. You will also be responsible for the next full month’s charges in the event that you do not provide the requisite ten (10) day notice of disconnection prior to the expiration of the then-current term. Expiration of the term or disconnection of Service will not excuse you from paying all accrued and unpaid charges due under this Agreement.