Virgin Valley Disposal, Inc.
501 Riverside Road
Mesquite, NV.  89027
702-346-5396

AUTHORIZATION FOR DIRECT PAYMENT

I hereby authorize Virgin Valley Disposal, Inc. to initiate debits from my
checking or savings  account named below.  I understand that I am responsible
to notify Virgin Valley Disposal, Inc. of any changes to my checking or 
savings account.

BANK________________________________ 	BRANCH_______________________________

CITY________________________________    STATE_____________  ZIP______________

ROUTING #___________________________    ACCOUNT #____________________________

CHECKING __________   SAVINGS__________   BUSINESS____________

FIRST_______________________________    LAST_________________________________

ADDRESS1____________________________    ADDRESS2_____________________________

CITY______________________________   STATE_________________  ZIP_____________

EMAIL ADDRESS_______________________    BIRTHDAY(MM/DD/YY)___________________

This authorization is to remain in full force and in effect until Virgin Valley 
Disposal, Inc. has received written notification from me to terminate this 
agreement.  Virgin Valley Disposal, Inc. and my bank shall have a reasonable 
opportunity to act on the request to terminate.

VIRGIN VALLEY DISPOSAL ACCOUNT #_____________________________________________

TODAYS DATE_________________  SIGNATURE______________________________________

A $25.00 processing fee will be assessed if there are insufficient funds in 
your bank account.

**PLEASE PROVIDE A VOIDED CHECK TO ENSURE PROPER ROUTING** 

NOTES & COMMENTS_____________________________________________________________

_____________________________________________________________________________

Official Use Only

Draft #_______________
Cycle#_______________
Processed By_________
Date_________________