I hereby authorize International Union of Operating Engineers, Local 564 to initiate debit entries to transfer funds from my bank account indicated on this form at the depository financial institution named. I agree that ACH transactions authorized herein shall comply with all applicable law.

Amount of debit(s) or method of determining amount of debit(s)

This authorization shall remain in full force and effect until the Company has received notification from me of its termination 30 days. Written notification must be received prior to the debit being processed in order to provide company and depository financial institutions a reasonable opportunity to act on notice of termination.