Credit Application Lumiere Place


*  Indicates field is required
Personal Information

Personal Information






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lbs
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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

Bank Account #1

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

Bank Account #2

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


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit




License Agreement

I represent and warrant that I am applying for credit from Casino One Corporation ("Lumiere Place") for my own personal gaming purposes. Casino credit is not intended to be used as a revolving credit line; it is strictly a privilege for gaming purposes and must be utilized in that manner. If the credit line is not utilized in accordance with the terms listed, management reserves the right to reduce or revoke the credit limit.

I certify that I have reviewed all of the information provided above and that it is true and accurate. I will advise Lumiere Place if any of this information changes. I authorize Lumiere Place 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 release and agree to hold harmless Lumiere Place, the financial institutions and/or reporting agencies from any and all liability for their use of the said information about me so provided or exchanged.

I agree that I am liable for the repayment of any and all credit that is extended to me by Lumiere Place. I waive any right, statutory or otherwise, to stop payment on any instrument issued in connection to any credit extended to me. I agree that the Lumiere Place may, at its discretion, apply any chips, slot tickets or jackpots presented by me to any outstanding balance due on my credit account with the remainder, if any, to be returned to me.

I agree that this application and all credit issued pursuant thereto will be governed, construed and interpreted pursuant the laws of Missouri. I authorize Lumiere Place to collect the funds due on any check that I write, including counter checks, drawn on any of my bank accounts, listed or not. If I do not fulfill any of the above obligations, I hereby authorize the Lumiere Place to provide the above information regarding me and my credit, employment, and account history to any agent, successor, or assignee for collection. I agree that Lumiere Place may litigate any dispute involving the credit line, the debt, or the payee in any court, state or federal, in Missouri. Should legal action be taken to collect an outstanding balance, I agree to pay all costs of collection, including reasonable attorneys' fees.

Privacy Policy

Click here to view the Privacy Policy for Lumiere Place.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Lumiere Place and its agent VisuaLimits, LLC ("VL") 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 Lumiere Place, VL 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 VL 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.

VisuaLimits, LLC ("VL") 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 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.