I certify that I am 21 years of age or older. I acknowledge that Hollywood Casino Columbus, Ohio may apply any chips, slot cash tickets or jackpots presented by me to the redemption of any outstanding or returned markers. I am aware that this application is required to be prepared by the regulations of the OCCC and I may be subject to civil and criminal liability if any material information provided by me is willfully false. I authorize Hollywood Casino Columbus, Ohio to conduct such investigations pertaining to the information as it deems necessary for the approval of my credit limit. I certify that I have reviewed all of the information provided above and that it is true and accurate. If this status changes, Hollywood Casino Columbus, Ohio must be notified. I hereby authorize Hollywood Casino Columbus, Ohio to investigate my credit record and to furnish information concerning such credit records to credit reporting agencies and others who may properly receive this information. This information can be for any account from which I now have or may in the future have the right to withdraw funds, regardless of whether that account now exists, or whether I provided the information on the account.

I authorize Hollywood Casino Columbus, Ohio to complete any of the following missing items on these credit instruments: (1) the name of a payee (2) any missing amounts (3) a date (4) the name, account number, and/or address and branch of any bank or financial institution and (5) any electronic encoding of the above items. Before drawing on my line of credit, if granted, I agree to sign credit instruments (ie.

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