Credit Application Four Queens and Binions Casinos

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
$
$
$
$
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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

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Gaming Information Other Casino Credit

Gaming Information Other Casino Credit





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License Agreement

TLC Casino Enterprises, Inc., Four Queens, LLC dba Four Queens Hotel and Casino (Four Queens), and Vintage Vegas Gaming, LLC dba Binions Gambling Hall and Hotel (Binions)

ENDORSE RESPONSIBLE GAMING: At your request, we will provide you with information on our self-limit program. If you or anyone you know may have a problem gaming responsibly, please call the 24-hour Problem Gamblers Help Line at 1-800-522-4700.

I give Four Queens and/or Binions authorization to obtain and verify at various times as it deems reasonable my financial information (including but not limited to bank account balance information) and employment history from any source.

I represent that at the time I sign any marker, I have on deposit in accounts on which I am an authorized signatory for all purposes, without restriction, funds sufficient to pay such marker upon demand or presentment.

I acknowledge that irrespective of any gambling, debt collection or currency exchange laws in the country in which I reside, I have the ability and intent to legally pay through my bank or financial institution the funds represented by the markers signed by me, and I hereby waive any such laws that may otherwise prohibit or limit my obligations as provided herein.

I agree that each marker I sign is a separate transaction. If I receive the funds before I execute a marker, I will promptly sign a marker when presented to me, in the amount of the funds I received.

I agree that any credit granted to me may be suspended or revoked at any time and without notice by the Four Queens and/or Binions, and I hereby release the Four Queens and/or Binions, including its officers, employees and agents, from any and all claims, damages or losses that I may incur as a result of such credit being suspended or revoked.

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.

Privacy Policy

Click here to view the Privacy Policy for Four Queens and Binions Casinos.

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

Signature

I, the undersigned, hereby authorize and instruct Four Queens and Binions Casinos 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 Four Queens and Binions Casinos, 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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