8/11/2019 3ACH

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EFA243

AUTHORIZATION AGREEMENT FOR PRE-AUTHORIZED PAYMENTS

To facilitate transactions associated with Equipment Financing Agreement# ___________________ betweenBALBOA CAPITAL CORPORATION, (hereinafter referred to as "Creditor") and

__________________________________________________________________________________ (hereinafter

referred to as "Debtor") Debtor hereby authorizes Creditor to initiate debit entries to the checking account indicated

below and Debtor hereby authorizes the depositing financial institution named below to enter such debits or credit tosuch account.

Name of Financial Institution ___________________________________________________

Account Number _______________________________________________

ABA Number _____________________________ (9 Digit number on bottom of check)

SSN/Tax ID# _____________________________

Please attach a copy of a voided check for the above account

It is understood that Creditor will process debit entries to the above-referenced account on or after the1stday of eachmonth in an amount not to exceed any amounts outstanding at any time, except as otherwise provided herein.

Debtor represents to Creditor that all persons whose signatures are required to withdraw funds from the above-

referenced account have executed this Authorization Agreement.

Debtor hereby acknowledges that Creditor may process debit entries forscheduled Equipment Financingpayments or

any other sum due and payable to Creditor pursuant to the referenced Equipment Financing between Creditor and

Debtor. Debtor also acknowledges that Creditor may assign Equipment Financing to a third party financing sourceand that assignee may then initiate debit entries per this authorization.

This authorization shall remain in effect until such further written notification is received from the

undersigned 14 business days before the due date.

Debtor hereby acknowledges that it has received a copy of this Authorization Agreement for its records.

"Delivery of this document bearing a facsimile signature or signatures shall have the same force and effect

as if the document bore an original signature."

Debtor Name: ______________________________________________________________________________

By: ___________________________________________

Name: ________________________________________

Title: ________________________________________

Date: ____________________

Additional signatories, if any required to withdraw funds from the above-referenced account:

Print Name and Title: Print Name and Title:

By: By:

(Signature) (Signature)

203592-000

GALENA EQUIPMENT RENTAL, LLC

GALENA EQUIPMENT RENTAL, LLC

08/12/14