1.14 APPLICATION FOR ADDITIONAL GAME OFFERING

APPLICATION FORM Page No. Page 1 of 2 FOR ADDITIONAL GAME Form No. EGLD - 390 OFFERING IN AN EXISTING GAMING VENUE Rev. No. 2 Remote Games Effectivity December 23, 2025 EG Form No. 12 EGLD Reference No.: _______________ SECTION A: GENERAL INSTRUCTIONS 1. Type or print all required information on the spaces provided. Incomplete applications shall be returned without action. 2. Email the clear scanned copies of duly accomplished EG Form No. 12 together with the prescribed initial documentary requirements to: [email protected] 3. Payment of applicable fees shall be made using EG Form No. 2. 4. Acceptance of this application for additional game offering and submission of documentary requirements does not guarantee approval of the application. The grant of license of a proposed additional game offering remains subject to approval of the PAGCOR Board. 5. Cut-off for submission is 4:00 P.M. Note: For inquiries regarding your application, please contact (02) 8521-1542, 8522-0299 loc. 1561 or send an email to the address above. SECTION B: APPLICATION DETAILS 1. Name of Applicant: __________________________________________________________ (Complete registered name) 2. Gaming Venue Address: __________________________________________________________ (Unit No / House No. / Floor Level / Building Name / Street Name) __________________________________________________________ (Barangay / Town / City / Municipality / Province) 3. Game Offering Details: Existing Game Offering/s: __________________________________________________________ Applied Game Offering: __________________________________________________________ Brand/s: __________________________________________________________ Gaming System Administrator/s (as applicable): _________________________________________ 4. Authorized Representative/s: __________________________________________________________ 5. Contact Number/s: __________________________________________________________ 6. E-mail Address/es: __________________________________________________________ SECTION C: INITIAL SITE REQUIREMENTS FOR ADDITIONAL GAME OFFERINGS Submitted Documentary Requirements Yes No   1. Mayor’s Permit or Business Permit for the conduct electronic gaming of the existing gaming site   2. Original and Notarized Board Resolution or Secretary’s Certificate on the new game offering(s) to be added in the existing gaming venue   3. Proposed gaming venue layout plan and site set-up concept renderings   4. Payment of Application Fee (to be Accomplished by EGLD)

APPLICATION FORM Page No. Page 2 of 2 FOR ADDITIONAL GAME Form No. EGLD - 390 OFFERING IN AN EXISTING GAMING VENUE Rev. No. 2 Remote Games Effectivity December 23, 2025 EG Form No. 12 EGLD Reference No.: _________________ SECTION D: DECLARATION By signing below, We declare that: 1. The information contained in this application including all documents submitted relative to this application are valid, true, and correct; 2. We understand that at this point, PAGCOR does not require any contractual agreement for the proposed additional game offering. Only in the event of PAGCOR's written approval of the Gaming License application for additional game offering shall we execute such agreement and likewise commence with the renovation of the site, if any. We will not hold PAGCOR liable for any rental/construction expenses that We may incur relative thereto. 3. We have executed this statement with the knowledge that misrepresentation or failure to reveal information requested may be deemed sufficient cause for disapproval/denial of this application or revocation of the Gaming License (GL) of Gaming Venue if application has been approved by the time such misrepresentation or act of omission is discovered. 4. We agree to abide by the provisions set forth in the guidelines. We understand that incomplete submission of the requirements will cause the non- processing of the application. 5. We are certifying that the proposed additional game offering is compliant with Local Government Unit(LGU) requirements and regulations on the conduct of this type of operations; and that We will not hold PAGCOR liable for expenses /"business losses" brought about by closure orders and/or penalties incurred should site be found non-compliant with LGU regulations. Printed Name: ____________________________________ Signature: ______________ (Authorized Signatory) Position Title: ____________________________________ Date: ______________ SECTION E: ACTION TAKEN (TO BE ACCOMPLISHED BY EGLD)  RETURNED APPLICATION due to: _____ Incomplete information or requirements _____ Applicant has decided to withdraw its application _____ Non-compliance with the submission of complete documentary requirements and/or failure to pay the applicable fees within the prescribed period  RECEIVED FOR PROCESSING with REFERENCE NUMBER: ____________________ Printed Name: ____________________________________ Signature: ______________ Position Title: ____________________________________ Date: ______________