Credit Application Golden Nugget Biloxi

Applying for

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Personal Information

Personal Information





* **


ft in
lbs
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** 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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$
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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

I, the undersigned Applicant, represent that statements made by me in this Credit Application are true and correct. I authorize Golden Nugget Biloxi, and/or any of its subsidiaries or affiliates to order a consumer credit report from a credit agency and to exchange pertinent information with others who may properly receive this information. I understand that any and all checks signed by me pertaining to this transaction may be micro-encoded, deposited and charged directly against any and all of the bank accounts designated.

I understand that knowingly providing false, inaccurate or misleading information on this credit application may subject me to criminal and/or civil liability.

1. The courts of the state where I am completing this credit application shall have jurisdiction to hear and determine any claim disputes pertaining directly or indirectly to this credit application or to any matter arising therefrom.

2. Each of the parties to this credit application hereby expressly submits and consents in advance to such jurisdiction in any action commenced by the other in the state courts.

3. I, the undersigned, agree that in the event this extension of credit need be placed with an attorney or agency, I will pay all costs of collection, including but not limited to, reasonable attorney’s fees, interest at the maximum rate allowed by law, court costs, filing fees, and any bank fees incurred through appeal.

4. I, the undersigned, agree to be liable for any and all extensions of credit.

Privacy Policy

Click here to view the Privacy Policy for Golden Nugget Biloxi.

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

Signature

I, the undersigned, hereby authorize and instruct Golden Nugget Biloxi 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 Golden Nugget Biloxi, 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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