EFA243

AUTHORIZATION AGREEMENT FOR PRE-AUTHORIZED PAYMENTS

To facilitate transactions associated with Equipment Financing Agreement#___________________ between
BALBOA 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 to
such account.

Name of Financial Institution ___________________________________________________
Account Number _______________________________________________
ABA Number _____________________________ (9 Digit number on bottomof 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 the1st day of each
month 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 fromthe above-
referenced account have executed this Authorization Agreement.

Debtor hereby acknowledges that Creditor may process debit entries for scheduled Equipment Financing payments 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 source
and 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