Gldd 980 Pullout And Transfer Clearance Request And Approval Form Crm F20

PULL-OUT AND TRANSFER Page No. Page 1 of 3 Form No. GLDD - 980 CLEARANCE REQUEST AND Revision APPROVAL FORM No. 6 (Licensee to Licensee) Effectivity Aug. 20, 2025 CRM FORM NO. 20 Use this form to request clearance from PAGCOR to pull-out equipment and/or paraphernalia from the casino for transfer to another licensee. Only requests with correct and complete information and supporting pull-out documents will be processed. Failure to provide correct and complete information could result in rejection of processing this request. PLEASE ALLOW TEN (10) BUSINESS DAYS FOR GLDD TO PROCESS YOUR REQUEST. SECTION A: PULL-OUT AND TRANSFER CLEARANCE REQUEST (TO BE FILLED OUT BY LICENSEE TRANSFEROR) Name of Licensee: ______________________________________________________________________ Casino Location: _______________________________________________________________________ This is to request approval to Gaming Table(s) Slot Machine(s) pull-out and transfer: Playing Card(s) Electronic Table Game(s) (Put an [X] mark on any of the Slot Spare Part(s) Chips/Plaques following) Table Layout(s) Game Conversion Kit(s) Surveillance Equipment Slot Machine Signage(s) Gaming Paraphernalia Table & Slot Management System Bill Validator/Acceptor Other Gaming Equipment Others (please specify) Attachment: Inventory List of Items for Pull-out and Transfer Description of Subject Item(s): Reason for pull-out & transfer: Destination: By: Licensee’s Authorized Signatory Date (Signature Over Printed Name) Request for Pull-out/Transfer of item/s should be accompanied by Confirmation of Accountability duly filled up and signed by the Licensee Transferee where the equipment and/or paraphernalia will be transferred. Licensee Transferor should request the Licensee Transferee of the gaming equipment to accomplish Section B of this form. SECTION B: CONFIRMATION OF ACCOUNTABILITY (TO BE FILLED OUT BY LICENSEE TRANSFEREE) hereby ASSUMES RESPONSIBILITY/ACCOUNTABILITY (Name of Licensee) for the abovementioned items that will be pulled-out from the ______________________________ upon transfer of the same to __________________________________. (Casino Location) (Destination) Further, our office/warehouse is available to PAGCOR for inspection and inventory of gaming machines, equipment and paraphernalia at anytime that may be deemed necessary by PAGCOR. By: Licensee’s Authorized Signatory Date (Signature Over Printed Name)

PULL-OUT AND TRANSFER Page No. Page 2 of 3 Form No. GLDD - 980 CLEARANCE REQUEST AND Revision APPROVAL FORM No. 6 (Licensee to Licensee) Effectivity Aug. 20, 2025 SECTION C: SUBMISSION INSTRUCTIONS Once Sections A and B are completed, please submit this form to GLDD via the PAGCOR Enterprise Content Management System (ECMS) which may be accessed through the following URL: www.ecms.pagcor.ph together with supporting pull-out documents. If submission of this form is done through the ECMS, an e-mail notification confirming receipt shall be received. The status of the application can be viewed and monitored through the online account created using the same system. Operator can also download and print the acknowledgment generated as proof of submission. If no e-email notification is received, the Operator may inquire from the Gaming Licensing & Development Department through the contact details: Tel. No. (+632)8522-0299/8522-1357/8522-1324 (Local 1148) SECTION D: ACTION TAKEN (TO BE FILLED OUT BY GLDD) A. RETURNED due to the following reasons: Incomplete information and/or supporting pull-out documents Incorrect information vis-à-vis supporting pull-out documents B. RECEIVED FOR PROCESSING with assigned REFERENCE NO. _________________ Printed By: Name: ______________________________ Signature: ________________________ Position Title: ______________________________ Date: ________________________ C. RECOMMENDATION FOR APPROVAL subject to Compliance Monitoring and Enforcement Department – Integrated Resort’s conduct of inspection and inventory prior to pull out and transfer of gaming equipment indicated above. Printed By: Name: ______________________________ Signature: ________________________ Position Title: ______________________________ Date: ________________________ Verified by: Approved by: Senior Manager, CLRU Assistant Vice President For endorsement to the following department/s INSPECTION AND INVENTORY OF SUBJECT ITEM/S FOR PULL-OUT AND TRANSFER T O: THE ASST. VICE PRESIDENT, CMED-IR ATTN: THE SENIOR MANAGER

PULL-OUT AND TRANSFER Page No. Page 3 of 3 Form No. GLDD - 980 CLEARANCE REQUEST AND Revision APPROVAL FORM No. 6 (Licensee to Licensee) Effectivity Aug. 20, 2025 Request to conduct an inspection and inventory of the approved Subject Item/s prior to pull-out and transfer of the same. Attachment: INVENTORY LIST OF ITEMS FOR PULL-OUT/TRANSFER PARTICULARS PAGCOR REMARKS NO. MANUFACTURER SERIAL NO. (Game Name, Brand, Model) TAG NO. (Note: Please use additional sheet/s if the space provided above is not sufficient)