Credit Application Choctaw Casino & Resort Pocola

Informational Questions

Please answer the following questions before completing and submitting the application

*  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
$
$
$
$
$
$
Primary Bank Information

Account #1

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

Account #2

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


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





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License Agreement

My signature is an authorization for Choctaw Nation of Oklahoma, d/b/a Choctaw Casino & Resort, to obtain and verify credit and employment information from any source including information pertaining to my personal and business accounts in accordance with applicable laws. I will not hold any financial institutions or current or former employers responsible for any information released.

By signing the credit request, you have agreed as follows:

You give the Choctaw Nation of Oklahoma and its representative’s permission to obtain and verify credit information from any source, to obtain your credit and employment history, and to exchange information with others about your credit and account experiences with the Choctaw Casino & Resort. You agree not to hold any of these entities responsible or liable for the information released. You agree that the Choctaw Casino & Resort will retain this application whether or not it approves the credit line.

Before drawing on your line of credit, if granted, you agree to sign credit instruments (i.e. checks) in the amount of the draw. You authorize the Choctaw Casino & Resort to complete any of the following missing items on these credit instruments: (1) the name of a payee, (2) any missing amounts up to the amount of the total draws, (3) a date, (4) the name, account number, and/or address and branch of any banks and financial institutions, and (5) any electronic encoding of the above items. This information can be for any account from which you now have or may in the future have the right to withdraw funds, regardless of whether that account now exists and whether you provided the information on the account to the Choctaw Casino & Resort.

You acknowledge that irrespective of any currency exchange laws in the country in which you reside, you have the ability and intent to legally repay any advance of money by the Choctaw Casino & Resort. You also acknowledge that an independent agent collecting front money deposits or payments on the debt is your agent and not an agent for the Choctaw Casino & Resort or any of its affiliates.

You fully, irrevocably, and voluntarily consent to the civil and where applicable, the criminal jurisdiction of the Choctaw Nation of Oklahoma (CNO) (the "Tribe" or "Tribal"), including but not limited to the jurisdiction of the Tribal Courts and the Tribal Gaming Commission, with respect to the interpretation and enforcement of this agreement, and your obligations under this agreement. You agree that the courts of the Tribe shall have exclusive jurisdiction over any and all claims and disputes arising hereunder, and that the parties hereto shall litigate any and all disputes hereunder, including but not limited to those involving the credit line, the debt, or the payee, exclusively in the courts of the Tribe. You consent and agree to be bound by any order or judgment of such Tribal court, and you hereby waive any and all objections to jurisdiction and venue in the Tribal courts.

You agree that this agreement shall be governed exclusively by federal law, as applicable, and by the laws of the Tribe, without regard to choice of law principles, and by other applicable laws relating to the regulation of Class II, Class III, and other gaming, including but not limited to the Tribal Gaming Ordinance. You further acknowledge and agree that this agreement has been awarded/granted by a governmental subdivision of the Tribe, and that it is to be performed solely within the Indian country jurisdiction of the Tribe. In addition to any amounts authorized by law, you will pay interest at the rate of 18% per annum from the date of execution of the credit instruments and all costs of collection, including attorney fees and court costs.

Warning: For the purpose of applicable law, a credit instrument is identical to a personal check and may be deposited in or presented 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 the account upon which it may be drawn, is a crime under federal and Tribal law which may result in criminal prosecution in addition to civil proceedings to collect the outstanding debt.

CHOCTAW CASINO & RESORT ENDORSES RESPONSIBLE GAMING. We will cancel or reduce your credit line upon your request. If you or anyone you know may have a problem gaming responsibly, please call 1-800-522-4700.

Privacy Policy

Click here to view the Privacy Policy for Choctaw Casino & Resort Pocola.

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

Signature

I, the undersigned, hereby authorize and instruct Choctaw Casino & Resort Pocola 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 Choctaw Casino & Resort Pocola, 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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