You will discover information about the type of form you want to prepare in the table. It can tell you how much time you'll need to complete parx casino credit, what parts you will have to fill in and some further specific facts.
| Question | Answer |
|---|---|
| Form Name | Parx Casino Credit |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | credit parx postal create, parx credit sample, credit parx address, parx credit get |
application for credit
casino credit is a credit line payable through a checking account. you will be issued a countercheck in exchange for chips or cash equivalent. the time period to remit payment for each countercheck is determined by it’s denomination. you will be required to return any unused countercheck balance prior to your departure from the casino. counterchecks may be paid directly or may be withdrawn from your checking account.
the maximum time period for counterchecks to be held before deposit is as follows: $1 up to $4,999 - 15 calendar days after the date of the countercheck
$5,000 or more - 30 calendar days after the date of the countercheck
please complete the form below, fax completed form to
account information
Xclub account number _________________________ |
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$ limit requested_____________ |
arrival date ______________ |
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personal data |
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first name ______________________________ |
mi ______ |
last name ________________________________________ |
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residential address _______________________________ |
city ____________________________________________________ |
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state ______ |
postal / zip code _____________ |
phone number______________________________________________ |
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date of birth |
social security number (no dashes) ______________________ |
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years at residence ________________________________ |
mail to _________________________________________________ |
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employment |
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position __________________________________________ |
type of business: |
❑ sole proprietorship ❑ retired |
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business phone number ___________________________ |
business address |
_______________________________________ |
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city ____________________________________ |
state ______ |
postal / zip code ________________________________ |
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years at _____ |
income _____________________ |
source income _______________ |
total assets _____________ |
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total personal debt _______________________________ |
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bank 1 information |
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branch * _________________________________________ |
address ________________________________________________ |
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city _____________________________ state __________________________ |
postal / zip code ______________________ |
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phone number __________________ type of account _________________ |
aba number __________________________ |
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account number ____________________________________________________________________________________________
bank 2 information
branch * _________________________________________ address ________________________________________________
city _____________________________ state __________________________ |
postal / zip code ______________________ |
phone number __________________ type of account _________________ |
aba number __________________________ |
account number ____________________________________________________________________________________________
disclosures
i certify that i have read and understand this application and its terms and i execute this document voluntarily and with full knowledge of its significance. i authorize parx casino to conduct any investigations necessary for the approval of my credit limit. i am aware that this application is required by the regulations of the pennsylvania gaming control board. i understand that a countercheck issued by parx casino is identical to a personal check and may be deposited in or presented for payment to my bank or other financial institution. i acknowledge that willfully drawing or passing a credit instrument with the intent to defraud, including knowing there are insufficient funds in my account is a crime in the commonwealth of pennsylvania that may result in criminal prosecution. i am also aware that providing false or misleading statements or omitting information on this application may subject me to civil or criminal penalties.
i certify that i am 21 years of age or older. i agree that parx casino may collect from me any reasonable costs or attorney fees incurred in connection with its efforts to collect any debt owed by me to parx casino. i agree that parx casino, in its sole discretion, may apply any and all gaming chips, jackpots or tokens, which i rightfully possess to reduce any debt owed by me to parx casino. i agree that parx casino may contact me at my home, my place of work or other location where i spend a significant portion
of each day. i agree that parx casino may furnish information contained in this credit application to credit reporting agencies, collection agencies, collection attorneys and others who may legally receive this information and take additional steps consistent with the laws of pennsylvania and the united states in connection with the investigation and verification of my financial resources and responsibility as well as the collection of any debt owed by me to parx casino. i agree that this application and all credit issued pursuant thereto will be governed, construed and interpreted pursuant to the laws of the commonwealth of pennsylvania. i agree that parx casino may litigate any dispute involving the credit line, the debt, or the payee in any state or federal court
in pennsylvania. i submit to the jurisdiction of any state or federal court in pennsylvania. i further represent that i have not been excluded from any gaming operation, nor have any of my privileges at any gaming operations been restricted, either voluntarily or by action of law.
would you like to be contacted by telephone as to the status of your request?
❑yes ❑ no
phone number: __________________________________________________________
please verify that you have read and agree to the above disclosures by signing below:
__________________________________________________________________________
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