Credit Application Silverton Casino

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

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

Warning: For the purposes of Nevada law, a credit instrument is identical to a personal check and may be deposited 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 a criminal prosecution in addition to civil proceedings to collect the outstanding debt.

I agree to pay my markers in full before 30 days or they will be deposited to my checking account on the 31st day after they were written.

I declare that the information set forth in this application is true and correct to the best of my knowledge. I give Silverton Casino, LLC or its representatives permission to obtain and verify credit information with any source (including banks I have listed or for any account from which I 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 the payee) to obtain credit, and/or employment history, and exchange information with others about my credit and account experience with Silverton Casino, LLC. I will not hold these firms responsible for any information released. Silverton Casino, LLC may use any information obtained to evaluate my application or status and to aid in the collections of my account. With respect to the collection of my accounts, I (1) acknowledge that the debt shall be governed by Nevada law; (2) agree that any dispute involving the debt may be brought only in the state or federal court in Nevada; (3) submit to the jurisdiction of any state or federal court in Nevada, and agree to pay all costs of collection, including the creditor’s attorney’s fees and court costs, in addition to any amounts authorized by law.

Privacy Policy

Click here to view the Privacy Policy for Silverton Casino.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Silverton Casino 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 Silverton Casino, 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.