Credit Application Primm Valley Resorts

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 cards, credit cards, and trust accounts 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 trust accounts 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/We the undersigned, represent(s) that all statements made by me/us in this agreement are true and correct. I/We authorize PRIMM VALLEY CASINO RESORTS or any of its affiliates to order a consumer report from a credit-reporting agency or permission to obtain information regarding my/our account with the banks I/We have listed, and/or to exchange pertinent information with others who may properly receive this information. I/We understand that all markers are to be PAID IN FULL WITHIN 30 DAYS OF ISSUE. I/We understand that any and all checks signed by me/us pertaining to this transaction may be micro-encoded, deposited and charged directly against any or all of the bank accounts designated above. I/We further understand that knowingly providing false inaccurate or misleading information of this credit agreement may subject me/us to criminal and/or civil liability. WARNING: 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 another 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 may result in a criminal prosecution in addition to civil proceedings to collect the outstanding debt.

Privacy Policy

Click here to view the Privacy Policy for Primm Valley Resorts.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Primm Valley Resorts 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 Primm Valley Resorts, 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.