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Years at Address. Responsible Gaming Policy. Zip Postal Code. Bank Name Credit Union Name. Click for Metric Metric. Do you play slots or tables? I Accept.{/INSERTKEYS}{/PARAGRAPH} Association with Business. Are you past due on any of your accounts? 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. Other Phone. Account Type Personal Business. 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. Branch City. 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. Sign Here. NRT Technologies, Inc. Do you understand that approval may take up to days? Click if retired Retired. Click if Self-Employed Self-Employed. Do you understand that this is an on-demand account that will be linked to your checking account for payment? How many times do you visit casinos per year? Do you understand that funds advanced are to be used only for gaming purposes during this trip? Do you have credit at a Caesars Entertainment property utilized within 18 months? Account Number Checking Account Number. No Yes. Have you visited our casino before? Do you understand that the funds being requested must be available in the account referenced on the application? Spouse's Name. Is your bank account negative? {PARAGRAPH}{INSERTKEYS}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? 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. Primary Bank Information Account 1 Pre-paid debit cards, credit cards, and loan accounts are not valid options. Branch Address. Employment Information. Physical Signature. When was the last time you visited a casino? I authorize Joker's Wild Casino Las Vegas, 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. Click here if Visually Impaired. 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? Use your mouse or touchscreen to sign above. Privacy Policy. Middle Name. Secondary Bank Information Account 2 Pre-paid debit cards, credit cards, and loan accounts are not valid options. License Agreement. Notify me 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. Other Casino Name. Do you wish to be notified prior to deposit? Is Account a Trust?