seneca casinos credit application - Seneca Buffalo Creek Casino

SENECA CASINOS CREDIT APPLICATIONPlease complete and return this credit application as soon as possible. We will process this information upon receipt, provided this form is filled out entirely andsigned in the appropriate place. Upon arrival, two (2) forms of identification (I.E. driver’s license, passport, military I.D.) will be required to activate your credit line.PLAYER INFORMATIONCredit Limit Requested: $Name:Date of Birth:Street Address:Players Club Membership #:Social Security #:Home Phone #:EMAIL:city:state:years at this address:ANNUAL INCOME:Total Assets:Total debt:MAIL to be SENT TO:HOMEBUSINESSCALL TO:HOMEBUSINESSEMPLOYER/BUSINESS INFORMATIONName of EMPLOYER/business:position with EMPLOYER/business:type of business:Sole propRietor? Y NEMPLOYER/business Address:city:STATE:ZIP:Years with business: business PHONE #:CREDIT LIMITS AT OTHER CASINOSCASINO:LIMIT:CASINO:LIMIT:Seneca Gaming Corporation • 310 Fourth Street, Niagara Falls, NY 14303 • 1-877-8-SENECA • SenecaCasinos.comFORM CONTINUESON NEXT PAGE

SENECA CASINOS CREDIT APPLICATIONBANK ACCOUNT INFORMATION(Only PERSONAL checking accounts or SOLE PROPRIETOR business accounts will be accepted)BANK 1:ROUTING #:Street Address:city:STATE:ZIP:ACCOUNT #:PERSONALSole propRietorSole propRietor ACCOUNT TITLEBANK 2:ROUTING #:Street Address:city:STATE:ZIP:ACCOUNT #:PERSONALSole propRietorSole propRietor ACCOUNT TITLEPRIVACY DISCLOSURESeneca Gaming Corporation restrictsaccess to personal information collectedfrom our customers to those individualswho need to know the information inorder to process credit applicationsor provide other services. We maintainphysical, electronic and proceduralcontrols to safeguard nonpublicpersonal information. Seneca GamingCorporation does not disclose anyinformation about current or formercustomers to anyone except asrequired by law.RELEASE AUTHORIZATION TO ALL FINANCIAL INSTITUTIONS/CREDIT REPORTING AGENCIESI authorize Seneca Gaming Corporation to conduct an inquiry into my credit worthiness including obtaining one or more consumercredit reports for the purpose of the evaluating my credit worthiness in connection with this application. You are hereby authorizedto release any and all information pertaining to said inquiry, as required by an appropriate employee or agent of Seneca GamingCorporation. A photocopy/facsimile of this authorization will be considered as effective and valid as the original.CUSTOMER SIGNATUREFax or Mail the Completed Form back to the following:Please fax to:(716) 501-2777Seneca Gaming CorporationAttn: CREDIT DEPARTMENTPlease mail to:Seneca Gaming CorporationAttn: CREDIT DEPARTMENT310 Fourth Street Niagara Falls, NY 14303DATE:If you have any questions,please call contact theCredit Executive on duty at1-877-873-6322 ext. 2442Seneca Gaming Corporation • 310 Fourth Street, Niagara Falls, NY 14303 • 1-877-8-SENECA • SenecaCasinos.com