Credit Application Peppermill Casino - Wendover

Applying for

*  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 and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Bank Account #2

Pre-paid debit and credit cards 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 give permission to Peppermill, Rainbow and Montego Bay Casinos, hereafter known as PCW, to obtain information regarding my account at the above named financial institution or elsewhere. I agree not to hold any of these financial institutions responsible for the accuracy or completeness of any information released to PCW. I authorize verification on all information provided on my application and the exchange of information about me, including requests to or from consumer reporting agencies. I agree that any monies paid to PCW or the proceeds of any chips I redeem, may be applied by PCW at its discretion to any debt owed by me to PCW. I agree to submit to the jurisdiction of any state or federal court in the state of Nevada, as well as jurisdiction of any other court where I reside, Have assist or am otherwise subject to. I agree the laws of the State of Nevada will govern any collection action. In the event of collection action, I agree to pay, in addition to any amounts authorized by law, all costs of collection, including PCW’s attorney’s fees and court costs. The undersigned irrevocably authorizes and empowers PCW to fill in and supplement any items of information in any promissory note issued by the undersigned to PCW, which may include but is not limited to, the issuance date, the principal amount of the note and the place of payment. I further agree this authorization may not be revoked without the prior written consent of PCW. This authorization shall be governed by the laws of the State of Nevada.

NOTICE: For the purposes of Nevada law, a credit instrument is identical to a personal check and may be deposited in or presented for payment to a bank or other financial institution on which the credit instrument is drawn. Willfully drawing or passing a credit instrument with the intent to defraud, including knowing that there are insufficient funds in an account upon which it may be drawn, is a crime in the State of Nevada which any result in criminal prosecution in addition to civil proceedings to collect the outstanding debt.

Privacy Policy

Click here to view the Privacy Policy for Peppermill Casino - Wendover.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Peppermill Casino - Wendover 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 Peppermill Casino - Wendover, 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.