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


AUTHORIZATION FOR E-MAIL / FAX

I hereby authorize Virgin Valley Disposal, Inc. to start sending my 
Invoice/Statements in the from of E-Mail and/or Fax.

PLEASE SEND MY INVOICE/STATEMENTS IN THE FORM OF…

__	E-MAIL 		E-Mail Address: ________________________________________

__	FAX		Fax Number: ____________________________________________


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. shall have a reasonable opportunity to 
act on the request to terminate.

MY NAME_________________________________________________________________________

VIRGIN VALLEY DISPOSAL ACCOUNT #________________________________________________

TODAYS DATE_____________________________________________________________________

SIGNATURE_______________________________________________________________________


NOTES & COMMENTS________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Official Use Only

Draft #_______________
Cycle#_______________
Processed By_________
Date_________________