Hollywood Casino Jamul - Credit Application

Credit Application Hollywood Casino Jamul

* Indicates field is required

Personal Information

First Name *

Middle Name

Last Name *

Suffix

AKA

Gender *

Are you applying for someone else? *

First and Last Name *

Country * (US applicants only)

Address *

Years at Address *

Main Phone *

Other Phone

Email Address *

Preferred Contact Method *

Send Mail to

Country

Address *

Statements Sent To *

Social Security # Social Insurance # (SIN) International ID

Date of Birth *

Country of Birth *

Mother's Maiden Name *

Spouse's Name

Driver's License # * **

Expiration * **

Passport #

Country

Expiration

Height * ft in

Weight * lbs

Height * cm

Weight * kg

Hair Color *

Eye Color *

** You must provide a Passport or Driver's License

** International Applicants must provide a Passport or International ID

Trip Information

Referred by (if not referred, enter N/A) *

Player # (if applicable) *

Reservation # *

Arrival Date *

Trip Occasion *

Credit Requested *

Employment Information

Employer / Name of Firm Name of Your Business Previous Employer *

Type of Business *

Number of Years *

Position *

Annual Income *

Business Phone *

Fax *

Country *

Business Address *

New Jersey Gaming Declaration *

Are you a gaming related casino employee, a state officer or employee, member of judiciary or legislature, or an officer of a municipality or county in New Jersey?

Financial Information

Insider of Public Company *

Politically Exposed Person/Relative or Associate *

Marijuana Related Source of Income *

Source of Income *

Investments Held With *

Pension Employer *

Savings Location *

Name of Spouse *

Other Source of Income *

Total Assets *

Source of Wealth *

Estimated Annual Compensation *

Estimated Total Annual Income *

Estimated Tax Bracket *

Estimated Liquid Net Worth *

Estimated Total Net Worth *

Total Amount of Indebtedness *

Source of Funds *

Account #1

Pre-paid debit and credit cards are not valid options.

Branch Country

Financial Institution Type *

Bank Name Credit Union Name *

Bank Routing Number Credit Union Routing Number *

Brokerage Firm *

Account Number Checking Account Number *

Brokerage ID Member ID

Account Type *

* Applicant must be the sole proprietor of this account

Association with Business *

Is Account a Trust? *

Branch Address *

Bank Officer *

Phone *

Account #2

Pre-paid debit and credit cards are not valid options.

Branch Country

Financial Institution Type

Bank Name Credit Union Name

Bank Routing Number Credit Union Routing Number

Brokerage Firm *

Account Number Checking Account Number

Brokerage ID Member ID

Account Type

* Applicant must be the sole proprietor of this account

Association with Business

Is Account a Trust?

Branch Address

Bank Officer *

Phone *

Do you wish to be notified prior to deposit?

Gaming Information Other Casino Credit

Do you have Credit at other casinos? *

Please provide at least one casino where you have credit
If you do not see the casino listed, select 'Other' and enter the casino name in the space provided

Casino *

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Do you have credit at a Caesars Entertainment property utilized within 18 months?

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Signature

Date

License Agreement

Casino credit is an extension of credit for the sole purpose of gaming. Guests with a verified loss have thirty-days to pay the balance. Guests without a verified loss are expected to pay markers on departure. Markers not used for gaming purposes may be deposited the following business day. Check payments are for immediate deposit and credit up to the amount of the check may be unavailable for up to 10 days. Guests who return at a later date and utilize a credit line while there is an outstanding balance must redeem current trip marker(s) first. Any additional funds may then be applied to the oldest marker(s) after all current trip marker(s) have been paid in full. Casino credit is not intended to be used as a revolving credit line; it is strictly a privilege for gaming purposes and must be utilized in that manner. If the credit line is not utilized in accordance with the terms listed, management reserves the right to reduce or revoke the credit limit.

I certify that I have reviewed all information provided and that it is accurate. I agree that I am 21 years of age or older. I authorize Hollywood Casino Jamul and its agents to conduct such investigations pertaining to information, as it deems necessary, for the approval and regular updating of my credit worthiness and to furnish information concerning such credit record to credit reporting agencies and others who may properly receive this information. With respect to the collection of my account(s), (1) I consent to binding arbitration conducted in accordance with the Jamul Indian Village Arbitration Ordinance No. 2015-32 and the Commercial Arbitration Rules of the American Arbitration Association in effect at the time of submission; (2) I submit to the jurisdiction of the Jamul tribal court, the Intertribal Court of Southern California, and, for the sole purpose of enforcing judgments, any state or federal court; (3) I agree to pay all cost of collection, including Hollywood Casino Jamul attorneys’ fees and court costs, in addition to any amounts authorized by law; and (4) I consent to Tribal law, as defined below.

This Agreement shall be governed by, construed and enforced in accordance with the internal laws of the Jamul Indian Village (/”Tribal Law/”), the laws of the State of California to the extent the same do not conflict with the laws of the Jamul Indian Village, and finally, federal law to the extent applicable. Nothing herein shall be deemed a waiver of sovereign immunity of Jamul Indian Village or any of its employees, agents, officials, department, or entities, including, without limitation, Jamul Indian Village Development Corporation.

Privacy Policy

Click here to view the Privacy Policy for Hollywood Jamul Casino.

Click here to view the Privacy Policy for NRT Technologies, Inc. and VisuaLimits, LLC

* I acknowledge that I have read and accept the above privacy policies

Signature

I, the undersigned, hereby authorize and instruct Hollywood Casino Jamul and its agent NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") and its affiliates to obtain consumer reports, to contact financial institutions, and to check my consumer credit, employment, bank and gaming history in order to evaluate my credit application as well as to update and/or review my account to provide services requested by me, as necessary or as required by law. I authorize Hollywood Casino Jamul, NRT or its affiliates to verify such information through any source and to report any information to another casino, excluding credit report data obtained from a credit agency, and to exchange any information with any of the affiliates of the Company. I hereby release and waive, and agree not to bring at any time in the future, any claims or demands against NRT or its affiliates relating to any credit investigation made pursuant to my authorization and instructions herein, including, without limitation, the collection, processing, and transmission of my information and data.

NRT Technologies, Inc. and VisuaLimits, LLC. ("NRT") promotes responsible gambling. By entering my name in the signature field and clicking the "I Accept" button below, I acknowledge that I have read the NRT Technologies, Inc. and VisuaLimits, LLC. Responsible Gaming Policy.

By entering my name in the signature field and clicking the "I Accept" button below, I hereby represent, warrant, and agree that all information provided herein is true and correct, that I am the person for whom I am requesting credit, and that I have read, understand, and agree to be bound by all of the terms herein.

I hereby acknowledge and agree that this Application may be signed electronically and that such electronic signatures shall be deemed an original for all purposes. I represent and warrant that by signing this Application electronically or causing this Application to be signed electronically that I have the authority to do so and that such electronic signature shall be sufficient to bind the respective party under this Application.

Physical Signature

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Signature

Date