Credit Application Palace Casino Resort


*  Indicates field is required
Personal Information

Personal Information






ft in
lbs
cm
kg

Trip Information

Trip Information

$

Employment Information

Employment Information

$

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

Financial Information
$
$
$
$
$
Primary Bank Information

Bank Account #1

Pre-paid debit cards, credit cards, and savings are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Bank Account #2

Pre-paid debit cards, credit cards, and savings are not valid options.
 * Applicant must be the sole proprietor of this account


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit

$
$
$


License Agreement

I authorize the Palace Casino Resort to obtain information regarding my account(s) with the financial institutions listed or any institutions subsequently discovered, to order consumer reports from a credit reporting agency, and to exchange information with others who may properly receive this information. I will not hold any of these institutions responsible for any information released. I agree: 1) to submit to the jurisdiction of any state or federal court in Mississippi, 2) that said actions shall be governed by the laws of the State Of Mississippi, 3) to pay interest on the amounts found due at the rate of 8% per annum, and 4) to pay reasonable costs and attorney’s fees incurred. Any drafts not redeemed on departure will be deposited in 14 days.

Privacy Policy

Click here to view the Palace Casino Resort Privacy Policy.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Palace Casino Resort and its agent VisuaLimits, LLC ("VL") 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 Palace Casino Resort, VL 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 VL 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.

VisuaLimits, LLC ("VL") 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 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.