I certify that the electronic media record of my transaction held by Slot Fever Casino shall be used as the final determination to resolve any dispute I may have. I clearly understand it is my sole responsibility, if applicable, to report my financial information to my respective Government, Customs, or Tax jurisdiction. I acknowledge that I have read all the information contained in Slot Fever Casino license and agree to follow by all the rules, terms, conditions, and agreements therein and as amended from time to time.
(Please clearly complete ONE form for every Credit Card you have used to deposit If it applies)
After the form is completed and signed, and all necessary documents are attached, fax to: Toll free number: 1-800-551-6087, International: + (506)-256-5502, or send scanned copies to . For Customer Service, call: 1-800-480-2147. Please remember to hand sign the form. * Information Required.