Credit Application Aquarius

*  Indicates field is required
Personal Information

Personal Information

* **
* **
* **
ft in
lbs
cm
kg
** You must provide a Passport or Driver's License
** International Applicants must provide a Passport or International ID
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
See PEP definition
X

Domestic PEP

A domestic PEP is a person who holds — or has held within the last 5 years — a specific office or position in or on behalf of the Canadian federal government, a Canadian provincial government, or a Canadian municipal government, for example:

  • Governor General, lieutenant governor or head of government;
  • member of the Senate or House of Commons or member of a legislature;
  • deputy minister or equivalent rank;
  • ambassador, or attaché or counsellor of an ambassador;
  • military officer with a rank of general or above;
  • pesident of a corporation that is wholly owned directly by Her Majesty in right of Canada or a province;
  • head of a government agency;
  • judge of an appellate court in a province, the Federal Court of Appeal or the Supreme Court of Canada;
  • leader or president of a political party represented in a legislature; or
  • ayor, reeve or other similar chief officer of a local government (municipal governments include cities, towns, villages and rural (county) or metropolitan municipalities).

Foreign PEP

A foreign PEP is a person who holds or has held one of the following offices or positions in or on behalf of a foreign state:

  • head of state or head of government;
  • member of the executive council of government or member of a legislature;
  • deputy minister or equivalent rank;
  • ambassador, or attaché or counsellor of an ambassador;
  • military officer with a rank of general or above;
  • president of a state-owned company or a state-owned bank;
  • head of a government agency;
  • judge of a supreme court, constitutional court or other court of last resort; or
  • leader or president of a political party represented in a legislature.

HIO

The head of an international organization is a person who is either:

  • the head of an international organization established by the governments of states; or
  • the head of an institution established by an international organization.
  • an international sports organization.

When we refer to the head of an international organization or the head of an institution established by an international organization, we are referring to the primary person who leads that organization, for example a Managing Director, Director-General, President, CEO etc.

$
$
$
$
$
$
Primary Bank Information

Account #1

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

Account #2

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

Instant Bank Account VerificationSpeeds up approval!

  • This is safe, secure, encrypted, and fast
  • You will need: bank login and bank account information
  • No bank login information is retained by the casino

Gaming Information Other Casino Credit

Gaming Information Other Casino Credit


Sign Here
Use your mouse or touchscreen to sign above

License Agreement

By signing below, I/we authorize Aquarius LLC to obtain information regarding my accounts with the financial institutions listed or subsequently discovered, to request information from any credit reporting agency and to exchange pertinent information with others who may properly receive this information. I will not hold Aquarius LLC or any of the financial institutions or reporting agencies responsible for any information released. In consideration of this credit I (1) acknowledge this debt is incurred and payable in Nevada; (2) agree to submit to the jurisdiction of any federal or state court in Nevada to enforce this obligation; (3) agree to pay all collection costs including attorney fees, court costs and interest found due at the rate of 18% per annum; (4) waive any requirement of presentment; (5) waive any right statutory or otherwise, to stop payment on this check. I authorize the payee to complete any negotiable instrument as necessary for presentation or payment within 90 days or by agreement noted above. In the event that a check is returned for insufficient or uncollected funds, it may be re-presented electronically. I have read and understand all the information on this application. Under penalties of perjury, I certify the Number shown on this form is the correct Taxpayer Identification Number issued to me.

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 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 may result in criminal prosecution in addition to civil proceedings to collect the outstanding debt." My signature below indicates I read and understand this warning.

Privacy Policy

Click here to view the Privacy Policy for Aquarius Casino.

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

Signature

I, the undersigned, hereby authorize and instruct Aquarius 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 Aquarius, 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


Sign Here
Use your mouse or touchscreen to sign above