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REVOCATION OF INSTRUCTION TO REJECT TRANSACTIONS


The undersigned holder ("Cardholder") of the card(s) specified below (the "Card(s)") does hereby revoke any prior instruction given to Global Cash Access, L.L.C. ("GCA") to reject any cash advance or ATM transaction requested using the Card(s). This revocation shall become effective upon GCA removing the Card(s) from its computer systems as card(s) subject to a Complete Rejection Instruction (as defined in the Instruction to Reject Transactions previously submitted by Cardholder) or a Daily Limit Instruction (as defined in the Instruction to Reject Transactions previously submitted by Cardholder). Cardholder understands that (A) a Complete Rejection Instruction may only be revoked after one year has passed since the date of the instruction, and (B) a Daily Limit Instruction may be revoked at any time.

Cardholder represents and warrants to GCA that Cardholder has all right, power and authority to make this revocation on behalf of all joint holders of the Card(s). The undersigned authorizes GCA to obtain credit reports using the information provided herein for the purpose of verifying the undersigned's identity and authority to make this revocation. Cardholder agrees that GCA's acceptance of any prior instruction has been solely as an accommodation to the instructing party, without any consideration to GCA; therefore, in no event shall GCA bear any liability for its acceptance, rejection, compliance or non-compliance with such prior instruction or this revocation for any reason whatsoever. Cardholder hereby waives any claims against GCA in connection with any prior instruction or this revocation, including without limitation GCA's rejection of transactions pursuant to any prior instruction, GCA's failure to comply with any prior instruction or GCA's rejection of transactions prior to the effectiveness of this revocation, and Cardholder agrees to indemnify GCA against any liability arising from or relating to any prior instruction or this revocation, including, without limitation, any liability to any joint holders of the Card, VISA U.S.A., Inc., MasterCard International, Inc., Discover/Novus Inc, any debit network, the issuer of the Card(s), any acquiring or merchant bank involved in the processing of transactions involving the Card(s) or any gaming establishment.

Cardholder agrees that this revocation shall be governed in all respects by the laws of the State of California, without regard to any conflicts of laws provisions which may result in the application of the laws of any jurisdiction other than the internal law other the State of California. Cardholder agrees that any claim or controversy arising out of any prior instruction or this revocation shall be settled by final and binding arbitration under the Commercial Arbitration Rules of the American Arbitration Association in Santa Clara County in the State of California by three arbitrators, one of whom shall be selected by GCA, one of whom shall be selected by Cardholder and the third of whom shall be selected by the mutual agreement of the other two arbitrators. Judgment on any award rendered by the arbitrators may be entered in any federal or state court located in Santa Clara County in the State of California. The arbitrators shall award to the prevailing party, if any, as determined by the arbitrators, all costs, fees and expenses of such arbitration, including attorneys' fees.

Cardholder: ______________________________   ______________________________
 

(Signature)

 

(Print Name)

       
Card Number(s):

______________________________

  Optional Information:
  ______________________________   Phone: _______________________
  ______________________________   Fax:      _______________________
       
Date: ______________________________    
       
Billing Address:
(exactly as on
statements)

______________________________

   
______________________________    
______________________________    

 

This information will remain confidential, and will be used solely for the purposes set forth above. Should you have questions about the status of your instruction, please call Cheryl Dotson at (800) 833-7110 ext. 3006.

 
Mail the completed form to Global Cash Access, L.L.C., Attn: Cheryl Dotson, 3525 E Post Rd., Suite 120, Las Vegas, NV 89120, or fax to (702) 262-5039.