Binion's Gambling Hall

TLC Casino Enterprises

Privacy Request Form

*--- Indicates a Required Field

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Please fill out the following form and we will get back to you as soon as possible.

Customer Information

*Name:

*Postal Address:

*Email Address:

*Phone:

Pursuant to the TLC Privacy Policy, the above Customer hereby requests that TLC Casino Enterprises

Information Requests (check all that apply)

Please provide a list of the categories of the Customer's Personal or Sensitive Information which you have collected.
Please provide a list of the sources from which the Customer's Personal or Sensitive Information was collected.
Please describe the business purpose for which you collected the Customer's Personal or Sensitive Information.
Please provide a list of the categories of third parties to whom you have disclosed the Customer's Personal or Sensitive Information.
Please provide a list of the Customer's specific Personal or Sensitive Information which you collected.

Other Requests (check all that apply)

Please delete all of the Customer's Personal or Sensitive Information with the exception of information needed to comply with legal obligations, fulfill orders and complete transactions.
The Customer would like to opt out of having their Personal or Sensitive Information sold or shared.
The Customer would like to opt out of having their Personal or Sensitive Information used for TLC marketing purposes.
The Customer would like to opt out of having their Personal or Sensitive Information shared with business partners or third parties for purposes of marketing.
The Customer would like to opt out of having their Personal or Sensitive Information shared among the various individual resorts within TLC Resorts.
The Customer believes there are errors in their Personal or Sensitive Information which you collected and would like to correct that information (explain in detail below).
The Customer would like to opt out of having their Personal or Sensitive Information used for automated processing purposes (e.g., "Profiling").
The Customer would like to cancel their All Access Players' Club account, including deleting any of their Personal or Sensitive Information collected for that purpose.
The Customer would like to modify the communication preferences with respect to their All Access Players' Club account (explain in detail below).

Customer Signature: (use mouse or touch)

Date:

Agent (if applicable)

Name:

Postal Address:

Email Address:

Phone:

Agent Signature: (use mouse or touch)

Date: