Consent for One Time Debit

Deposit & Payment System

ONE-TIME DEBIT FORM

By completing the below consent, you authorize a one-time debit for your deposit or the remaining initial payment (and/or combination of documentation fees, as applicable) for the purchase of your commercial equipment, truck, or trailer.

It is understood that this debit will be completed on or after today's date by AMERICAN EQUIPMENT FINANCIAL SERVICES, LLC, and that this debit in no way impacts other standing agreement for recurring payments. By signing below, I certify that I am authorized to consent to electronic debits for the aforementioned account.

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We charge a one-time 3.6% fee for credit/debit card transactions.

Routing #*

Account #*

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Credit Card Account #*

Expiration Date - Month and Year*

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Name on the Above Account*

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Enter the Amount to be Debited*

Please Note: Entering the incorrect amount may delay funding or require additional documentation be completed.

CONSENT FOR PRE-AUTHORIZED DEBIT

I/we hereby authorize a one time debit (on the date of my execution of this document below), using the bank routing and account number provided, in the above amount, to secure the above proposal according to the aforementioned terms.

I am an authorized signer on this account and agree not to reverse or stop payment on said debit. By signing below, I indicate my acceptance of this proposal as of the date of my execution below and acknowledge that this letter contains the entire proposal, superseding all previous representations and agreements – either oral or written. There are no promises, agreements, or understandings outside of this letter.

CONSENT FOR PRE-AUTHORIZED DEBIT

I/we hereby authorize a one time charge on the date of my execution of this document below), using the card account number provided, in the above amount, to secure the above proposal according to the aforementioned terms.

I am an authorized signer on this account and agree not to reverse or stop payment on said charge. By signing below, I indicate my acceptance of this proposal as of the date of my execution below and acknowledge that this letter contains the entire proposal, superseding all previous representations and agreements – either oral or written. There are no promises, agreements, or understandings outside of this letter.

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Consent to Above Terms & Credit Release Authorization*

Applicant hereby authorizes American Equipment Financial Services, LLC, S&P Financial Services, Inc. (AKA SLS Financial), its nominees or assigns ("Creditor/Lessor"), to check Applicant's credit and bank records, and specifically authorizes all of its bankers and creditors to release to Creditor/Lessor any information Creditor/Lessor requests. By signing below: 1) the undersigned individual(s) authorizes Creditor/Lessor to review his/her personal credit profile from any commercial credit bureau for the purpose of extending or renewing any credit facility, or to collect the resulting account - understanding that a photostat, facsimile, or electronic copy of this authorization is valid as the original; 2) Applicant further affirms his/her identity as the respective individuals identified in application based on information provided through Application provided through the means specified above; 3) Applicant hereby affirms that he or she wishes to utilize American Equipment Financial Services, LLC and no other brokers with respect to their Application; 4) Applicant agrees to all above terms regarding a one time ACH debit or credit/debit card payment from the provided account.

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Deposit & Payment System

ONE-TIME DEBIT FORM

CONSENT FOR PRE-AUTHORIZED DEBIT

CONSENT FOR PRE-AUTHORIZED DEBIT

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