Notice of Imposition of Penalty Form
LLBC - RP Form 2 Page No. Page 1 of 1 NOTICE OF IMPOSITION OF PENALTY Form No. GLDD – 1676 Revision No. 0 Effectivity Aug. 13, 2025 Date: RP Docket No: Licensee: Address: Reference: SECTION A. VIOLATION SECTION B. PENALTY Particulars: Total Amount Due Due Date 15 days upon receipt of NIP We shall appreciate the settlement of the total amount due on or before due date to Landbank of the Philippines with the following account details: Account Name Account Number PAGCOR OPEX Fund C/A No. 3402-1036-70 SECTION C. REMINDERS 1. The Licensee may file a Motion for Reconsideration within fifteen (15) days from receipt of this Notice, provided the total penalty imposed has been paid under protest. 2. Payment will only be considered upon GLDD’s receipt of the bank validated deposit slip or issued Official Receipt. MA. VINA CLAUDETTE P. OCA Assistant Vice President cc: AVP, CMED-IR ACKNOWLEDGEMENT RECEIPT(To be filled out by the authorized signatory of Licensee/Gaming Operator) By: Printed Name: Signature: Position Title: Date: LLBC - RP Notice of Imposition of Penalty 1|Page
More in PAGCOR Forms
- Gldd 976 Gaming Chips And Plaques Request And Approval Form Crm F15
- Product Demonstration Request and Approval Form v2
- Gldd 973 Movement Of Electronic Gaming Machines Notification Form Crm F12
- Gldd 981 Pull Out And Transfer To Supplier Of Gaming Equipment Notification Form Crm F21
- Gldd 975 Change In Surveillance Plan Notification Form Crm F14
- OG Form 1175 - Resignation Termination Form (Form B)
- Notice on Shipment/Ship-out Processing Fee Payment Slip Form
- Gldd 989 Junket Runner Clearance Request And Approval Form Crm F35
Want an analysis of this document?
Ask ASG Legal AI to summarize it, compare it with other rulings, or explain how it applies to your situation — it researches from this same library.