JACK Entertainment - Credit Application

Credit Application JACK Entertainment

Informational Questions

Please answer the following questions before completing and submitting the application

When was the last time you visited a casino? *

How many times do you visit casinos per year? *

Do you play slots or tables? *

Are you past due on any of your accounts? *

Is your bank account negative? *

Do you understand this is not a loan or credit card, and that the balance is due in full at the end of your trip? *

Do you understand that by applying, we will pull a credit report? *

Have you visited our casino before? *

Do you have a player’s club card with our casino? *

Do you understand that this is an on-demand account that will be linked to your checking account for payment? *

Do you understand that the funds being requested must be available in the account referenced on the application? *

Do you understand that approval may take up to 29 days of trip? *

Do you understand that funds advanced are to be used only for gaming purposes during this trip? *

Do you understand that funds advanced are to be used only for slots or table games purposes? *

Apply For *

* Indicates field is required

Personal Information

First Name *

Middle Name

Last Name *

Suffix

AKA

Gender *

Are you applying for someone else? *

First and Last Name *

Country * (US applicants only)

Address *

Years at Address *

Main Phone *

Other Phone

Email Address *

Preferred Contact Method *

Send Mail to *

Country

Address *

Statements Sent To *

Social Security # Social Insurance # (SIN) International ID

Date of Birth *

Country of Birth *

Mother's Maiden Name *

Spouse's Name

Driver's License # * **

Expiration * **

Passport #

Country

Expiration

Height * ft in

Weight * lbs

Height * cm

Weight * kg

Hair Color *

Eye Color *

Do you wear glasses? *

** You must provide a Passport or Driver's License

** International Applicants must provide a Passport or International ID

Trip Information

Referred by (if not referred, enter N/A) *

Player # (if applicable) *

Reservation # *

Arrival Date *

Trip Occasion *

Credit Requested *

Employment Information

Employer / Name of Firm Name of Your Business Previous Employer *

Type of Business *

Number of Years *

Position *

Annual Income *

Business Phone *

Fax *

Country *

Business Address *

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

Insider of Public Company *

Politically Exposed Person/Relative or Associate *

Marijuana Related Source of Income *

Source of Income *

Investments Held With *

Pension Employer *

Savings Location *

Name of Spouse *

Other Source of Income *

Total Assets *

Source of Wealth *

Estimated Annual Compensation *

Estimated Total Annual Income *

Estimated Tax Bracket *

Estimated Liquid Net Worth *

Estimated Total Net Worth *

Total Amount of Indebtedness *

Source of Debt *

Mortgage/Loan Amount *

Credit Card Amount *

Other Amount *

Form of Funds *

Source of Funds *

* I understand that the casino may request documentation verifying the source of my funds. I agree to provide such documentation if requested and certify that all information provided in this application is true and accurate.

Account #1

Pre-paid debit and credit cards are not valid options.

Branch Country

Financial Institution Type *

Bank Name Credit Union Name *

Bank Routing Number Credit Union Routing Number *

Brokerage Firm *

Account Number Checking Account Number *

Brokerage ID Member ID

Account Type *

* Applicant must be the sole proprietor of this account

Association with Business *

Is this a Private Client Account? *

Is Account a Trust? *

Branch Address *

Bank Officer *

Officer Position *

Phone *

Account #2

Pre-paid debit and credit cards are not valid options.

Branch Country

Financial Institution Type

Bank Name Credit Union Name

Bank Routing Number Credit Union Routing Number

Brokerage Firm *

Account Number Checking Account Number

Brokerage ID Member ID

Account Type

* Applicant must be the sole proprietor of this account

Association with Business

Is this a Private Client Account?

Is Account a Trust?

Branch Address

Bank Officer *

Officer Position *

Phone *

Instant Bank Account Verification –
Speeds up approval!

If you want to speed up the approval process, click the Instant Verification button to complete the requested information and we will receive a read-only verification of your bank account status.

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

The Instant Bank Verification can be run on Personal Accounts from US and Canadian Banks only. Business Accounts are not available through the Instant Bank Verification service at this time.

Click on the accounts you would like to verify then click Proceed

Bank Name:
Routing Number:
Account Number:

Bank Name:
Routing Number:
Account Number:

The errors listed above need to be fixed before submitting Instant Bank Verifications for the selected accounts. Please return to the application and fix the errors

The following errors need to be fixed before submitting an Instant Bank Verification.

Please return to the application and fix the errors

Do you wish to be notified prior to deposit?

Gaming Information Other Casino Credit

Do you have Credit at other casinos? *

Please provide at least one casino where you have credit
If you do not see the casino listed, select 'Other' and enter the casino name in the space provided

Casino *

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Casino

Country

Limit

Do you have credit at a Caesars Entertainment property utilized within 18 months?

Sign Here

Signature

Date

License Agreement

I authorize JACK Home Property, and their respective subsidiaries, affiliates and agents (individually and collectively, "JACK") to conduct any investigations necessary for the approval of my requested credit limit, including by way of example, obtaining information regarding my account(s) from the financial institutions listed above, obtaining consumer credit reports, checking my credit, and verifying my employment history. I agree not to hold JACK responsible or liable for the information released, nor for JACK's use of such information. I agree that JACK has the right to revoke or modify any credit line issued at any time. Before drawing on my credit line, if granted, I agree to sign credit instruments (i.e., markers or checks) in the amount of the draw and agree to be bound by the terms therein. If I receive the advance before I execute a credit instrument, I will promptly sign a credit instrument in the amount of the advance. I authorize JACK to complete any of the following missing items on these credit instruments: (1) the payee’s name, (2) the draw amount, (3) the draw date, (4) the name, account number, address or branch of the bank or financial institution, and (5) any electronic encoding of the foregoing items. This information can be for any account from which I now have or may in the future have the right to withdraw funds, regardless of whether that account now exists, or whether I provided the information on the account to JACK. I agree that each draw against my credit line is a separate advance of money by JACK. I acknowledge and agree that with regard to any funds that I receive from JACK, I will have the same amount of funds available in the accounts of the financial institutions I have identified in this application, and that said funds are free of any claims, set-offs, or subject to any pay order, marker, or other instruments other than that issued in favor of JACK. I acknowledge and agree that in advancing me funds, JACK is relying upon each and every representation herein as being true and correct. I hereby authorize JACK, in its sole discretion, to apply any and all chips, cash, or cash equivalent I may redeem first to the reduction of any outstanding credit balance, with the remainder, if any, to be returned to me. I certify that I am 21 years of age or older. With respect to the collection of my accounts, I (1) acknowledge that the debt occurred in the State of my JACK Home Property, (2) agree that any dispute involving the debt may be brought in state or federal court sitting in the State of my JACK Home Property or state in which I reside, and (3) agree to pay interest on the amounts found due at the rate set forth in the credit instrument. I agree that any conflicting terms in future credit instruments I execute in JACK's favor shall prevail over the terms set forth in this credit application.

Must be 21 or older to gamble. Gambling Problem? Call 1-800-MY-RESET or visit www.org.ohio.gov.

Privacy Policy

Click here to view the JACK Entertainment Privacy Policy.

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

* I acknowledge that I have read and accept the above privacy policies

Signature

I, the undersigned, hereby authorize and instruct JACK Entertainment 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 JACK Entertainment, 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

Signature

Date

Credit Application JACK Entertainment

Informational Questions

Personal Information

Trip Information

Employment Information

Financial Information

Account #1

Account #2

Instant Bank Account Verification –
Speeds up approval!

Select an Account

You are currently verifying :

Gaming Information Other Casino Credit

License Agreement

Privacy Policy

Signature

Physical Signature

Credit Application JACK Entertainment

Informational Questions

Personal Information

Trip Information

Employment Information

Financial Information

Account #1

Account #2

Instant Bank Account Verification – Speeds up approval!

Select an Account

You are currently verifying :

Click on the accounts you would like to verify then click Proceed

You are currently verifying :

Please complete all steps of the verification process.

When finished click the Finish button below.

Gaming Information Other Casino Credit

License Agreement

Privacy Policy

Signature

Physical Signature

Instant Bank Account Verification –
Speeds up approval!