Marg1101 Credit App Manual P5R1
APPLICATION INFORMATION Date: Arrival Date: Limit Requested (Minimum $2,500): $ Last Name: First Name: Middle Initial: Date of Birth: SSN: Sex: Male Female Home Address: City: State/Country: Zip: Length of Residence at this Address: E-mail: Phone: Mobile Phone: Alternate Address: City: State/Country: Zip: Mail Correspondence: Home Business Alternate None Marketing Referral: Drivers License #: Expiration Date: Issuing State: EMPLOYMENT INFORMATION Current Employer: Employer Address: City: Position: Type of Business:
State/Country: Length of Employment:
Zip: Business Phone:
BANK ACCOUNT INFORMATION (Only PERSONAL CHECKING accounts or SOLE PROPRIETOR business accounts will be accepted.) Primary Bank: Branch Address: City: State/Country: Zip: ABA (Routing) #: Personal Acct #: Business Acct #: Bank Contact: Position: Business Name: Secondary Bank: Branch Address: City: State/Country: Zip: ABA (Routing) #: Personal Acct #: Business Acct #: Bank Contact: Position: Business Name: MARGARITAVILLEBOSSIERCITY.COM • 1-855-FIN-CITY PAGE 1 of 2
Please send to:
Margaritaville Resort Casino Attn: Credit Department P.O. Box 5456 Bossier City, LA 71171 This application may also be returned in person to the credit office.
PLEASE READ AND SIGN BELOW I hereby certify that I have reviewed all of the information provided above and that it is true and complete. I authorize Bossier Casino Venture, Inc. dba Margaritaville Resort Casino or its affiliates, (collectively, the “Company”), to conduct such investigations pertaining to the above information through any source for the approval and maintenance of my credit limit, including but not limited to obtaining a credit report from a national credit reporting agency. I am aware that this application is required to be prepared by the regulations of the Louisiana Gaming Control Board and I may be subject to civil or criminal liability if any material information provided by me is willfully false. I understand that the information provided by me to complete this application is provided for the purpose of inducing the Company to issue credit to me. I also certify that I am 21 years of age or older. I understand that Louisiana law prohibits persons under the age of 21 from engaging in gaming activity. Accordingly, I must be 21 years of age or older to apply for and obtain credit at the Company. I agree to pay all sums due as a result of credit extended, loaned, or advanced to me by the Company whether by way of chips, cash, tokens or checks within the time period determined as according to the guidelines set by the Company. I further authorize the Company to debit any of the accounts listed above in repayment of any of the sums that are not paid on or before the due date following the time period as determined by the Company. I authorize the Company, in its sole discretion, to apply any and all chips and tokens I may redeem, first, to the reduction of my outstanding credit balance with the remainder, if any to be returned to me. I agree that any partial payment on account of outstanding debt owing to the Company shall be deemed an acknowledgement by me of the total remaining balance of that outstanding debt. In the event an attorney is employed to collect the credit balance, I agree to pay the cost of such collection together with reasonable attorney fees. I agree that this application and all credit issued pursuant thereto will be governed, construed and interpreted pursuant to the laws of the State of Louisiana. For the purpose of any action for the enforcement or collection of any outstanding debt I owe or may owe in the future to the Company, I hereby submit to the personal jurisdiction of the state and federal courts sitting in Bossier City, Parish of Bossier, State of Louisiana and waive any requirement of presentment and waive any objection I may have to jurisdiction in such courts. In the course of providing credit and other financial services with the Company, we obtain certain personal information from our customers that may be considered confidential. We maintain physical, electronic and procedural protections to guard our customers’ confidential information. We do not disclose any of this information about our customers to anyone, except as required by law or regulatory agency. In the future it may be necessary to modify or supplement our privacy policies. Our customers will be informed of any changes to our policy in notices that we will provide as required by law. Bossier Casino Venture, Inc. dba Margaritaville Resort Casino supports responsible gaming. If you or anyone you know may have a problem gaming responsibly, please call the Problem Gamblers Help-Line at 1-800-522-4700.
Signature: Print Name: Date: MARGARITAVILLEBOSSIERCITY.COM • 1-855-FIN-CITY PAGE 2 of 2
State/Country: Length of Employment:
Zip: Business Phone:
BANK ACCOUNT INFORMATION (Only PERSONAL CHECKING accounts or SOLE PROPRIETOR business accounts will be accepted.) Primary Bank: Branch Address: City: State/Country: Zip: ABA (Routing) #: Personal Acct #: Business Acct #: Bank Contact: Position: Business Name: Secondary Bank: Branch Address: City: State/Country: Zip: ABA (Routing) #: Personal Acct #: Business Acct #: Bank Contact: Position: Business Name: MARGARITAVILLEBOSSIERCITY.COM • 1-855-FIN-CITY PAGE 1 of 2
Please send to:
Margaritaville Resort Casino Attn: Credit Department P.O. Box 5456 Bossier City, LA 71171 This application may also be returned in person to the credit office.
PLEASE READ AND SIGN BELOW I hereby certify that I have reviewed all of the information provided above and that it is true and complete. I authorize Bossier Casino Venture, Inc. dba Margaritaville Resort Casino or its affiliates, (collectively, the “Company”), to conduct such investigations pertaining to the above information through any source for the approval and maintenance of my credit limit, including but not limited to obtaining a credit report from a national credit reporting agency. I am aware that this application is required to be prepared by the regulations of the Louisiana Gaming Control Board and I may be subject to civil or criminal liability if any material information provided by me is willfully false. I understand that the information provided by me to complete this application is provided for the purpose of inducing the Company to issue credit to me. I also certify that I am 21 years of age or older. I understand that Louisiana law prohibits persons under the age of 21 from engaging in gaming activity. Accordingly, I must be 21 years of age or older to apply for and obtain credit at the Company. I agree to pay all sums due as a result of credit extended, loaned, or advanced to me by the Company whether by way of chips, cash, tokens or checks within the time period determined as according to the guidelines set by the Company. I further authorize the Company to debit any of the accounts listed above in repayment of any of the sums that are not paid on or before the due date following the time period as determined by the Company. I authorize the Company, in its sole discretion, to apply any and all chips and tokens I may redeem, first, to the reduction of my outstanding credit balance with the remainder, if any to be returned to me. I agree that any partial payment on account of outstanding debt owing to the Company shall be deemed an acknowledgement by me of the total remaining balance of that outstanding debt. In the event an attorney is employed to collect the credit balance, I agree to pay the cost of such collection together with reasonable attorney fees. I agree that this application and all credit issued pursuant thereto will be governed, construed and interpreted pursuant to the laws of the State of Louisiana. For the purpose of any action for the enforcement or collection of any outstanding debt I owe or may owe in the future to the Company, I hereby submit to the personal jurisdiction of the state and federal courts sitting in Bossier City, Parish of Bossier, State of Louisiana and waive any requirement of presentment and waive any objection I may have to jurisdiction in such courts. In the course of providing credit and other financial services with the Company, we obtain certain personal information from our customers that may be considered confidential. We maintain physical, electronic and procedural protections to guard our customers’ confidential information. We do not disclose any of this information about our customers to anyone, except as required by law or regulatory agency. In the future it may be necessary to modify or supplement our privacy policies. Our customers will be informed of any changes to our policy in notices that we will provide as required by law. Bossier Casino Venture, Inc. dba Margaritaville Resort Casino supports responsible gaming. If you or anyone you know may have a problem gaming responsibly, please call the Problem Gamblers Help-Line at 1-800-522-4700.
Signature: Print Name: Date: MARGARITAVILLEBOSSIERCITY.COM • 1-855-FIN-CITY PAGE 2 of 2
