I hereby agree to indemnify and hold harmless the New Palace Casino LLC, their respective officers, directors, employees and agents from any and all claims, suits, causes of action, liabilities, costs, losses, damages and expenses which I, or any third party, might have or incur as a result of this information. By executing this document I hereby request the New Palace Casino LLC, furnish me with the requested win/loss or W2G documentation for my personal use. I hereby certify that I am the person named in this request and all information is true and accurate.
