Credit Application

Fields marked with an asterisk (*) are required

Enjoy Club Account #

Date

Last name: *

Name: *

Marital Status: *

Spouce Name: *

Address: *

City: *

Country: *

Zip Code: *

Business/Office Address: *

City: *

Country: *

Zip Code: *

Type of Business: *

Position: *

Annual Income: *

Cell Phone: *

Business Phone: *

ID#: *

SS#: *

Country: *

Date of Birth

Type of identification:

Passport

Driver´s License

Other

E-mail: *

Credit Requested (USD Dollars): *

Politically Exposed Person (PEP) / Relative or Associate:

Yes

BANK INFORMATION

Bank: *

Account #: *

Account Type: *

Address: *

Country: *

Zip Code: *

I understand and acknowledge that I have reviewed all the information provided in this application and it is correct and true. In the event any information changes, I will timely notify Enjoy Punta del Este. I hereby authorize Enjoy Punta del Este or its affiliates to obtain consumer reports, contact financial institutions, and check my financial, consumer credit, employment, bank and gaming history to evaluate my credit application as well as to update and review my account to provide services requested by me, which will determine the approval or not of the requested credit. I further authorize Enjoy Punta del Este to provide any information to other casinos or credit agencies, exchange information with any affiliate of the company. I declare under oath that I have fulfilled all my tax obligations in all applicable jurisdictions (including customs tax obligations).