Gldd 981 Pull Out And Transfer To Supplier Of Gaming Equipment Notification Form Crm F21

Page No. Page 1 of 4 PULL-OUT AND TRANSFER TO Form No. GLDD - 981 SUPPLIER OF GAMING EQUIPMENT Revision NOTIFICATION FORM 6 No. Effectivity Aug. 20, 2025 CRM FORM NO. 21 Use this form to notify PAGCOR regarding pullout and transfer to supplier of gaming equipment. Please accomplish this form by providing correct and complete information. The Licensee shall submit this form to GLDD at least one (1) business day prior to intended date of implementation. PLEASE NOTE THAT PAGCOR RESERVES THE RIGHT TO CONDUCT POST-AUDIT OF THE GAMING EQUIPMENT WHICH HAS BEEN PULLED OUT FROM THE CASINO’S GAMING AREA FOR TRANSFER TO THE SUPPLIER. Licensee : Name of Casino : Date : Date of Implementation : SECTION A: PROPOSED PULLOUT AND TRANSFER OF GAMING EQUIPMENT (TO BE PROVIDED BY LICENSEE) Please be informed of the pullout and transfer to supplier of the following gaming equipment: Gaming Table(s) Slot Machine(s) Playing Cards(s) Electronic Table Game(s) Slot Spare Part(s) Chips/Plaques Table Layout(s) Game Conversion Kit(s) Surveillance Equipment Slot Machine Signage(s) Gaming Paraphernalia Casino Management System for Table & Slot Bill Validator/Acceptor Other Gaming Equipment Attachment: Inventory list of items for Pullout and Transfer to Supplier Description of Subject Item(s): Reason for Pullout and Transfer: Destination: _____________________________ ____________________ Licensee’s Authorized Signatory Date (Signature over printed name) Request for Pull-out/Transfer to Supplier of item/s should be accompanied by Confirmation of Accountability duly filled up and signed by Licensee’s Supplier. Licensee should request their supplier to accomplish Section B of this form.

Page No. Page 2 of 4 PULL-OUT AND TRANSFER TO Form No. GLDD - 981 SUPPLIER OF GAMING EQUIPMENT Revision NOTIFICATION FORM 6 No. Effectivity Aug. 20, 2025 SECTION B: CONFIRMATION OF ACCOUNTABILITY (TO BE FILLED OUT BY LICENSEE’S SUPPLIER) hereby ASSUMES RESPONSIBILITY/ACCOUNTABILITY (Name of Supplier) 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: ______________________________ _______________________ Supplier’s Authorized Signatory Date (Signature over Printed Name) We confirm and undertake to do the following: a. The conduct of inspection and inventory prior to pullout of gaming equipment from the gaming area for transfer to supplier shall be coordinated with the Compliance Monitoring and Enforcement Department – Integrated Resorts and the PAGCOR Monitoring Team. b. The conduct of pullout and transfer to supplier of gaming equipment is compliant with the requirements set forth in Regulation 12 Section 5 of the Casino Regulatory Manual for Licensed Land-Based Casinos. Name of Requestor : Signature : Position Title : Date: 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 along with the necessary attachments. 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)

Page No. Page 3 of 4 PULL-OUT AND TRANSFER TO Form No. GLDD - 981 SUPPLIER OF GAMING EQUIPMENT Revision NOTIFICATION FORM 6 No. Effectivity Aug. 20, 2025 If submission of this notification form is done thru e-mail, the Licensee should ensure that it has been duly received and acknowledged by GLDD. The Licensee shall be notified by GLDD thru e-mail confirming receipt of this notification form. If no e-mail confirmation is received from GLDD, the Licensee should submit the notification form’s hard copy directly to GLDD. SECTION D: ACKNOWLEDGEMENT OF NOTIFICATION (TO BE FILLED OUT BY GLDD) RECEIVED with REFERENCE NO. _________________ By: Printed Name: Signature: Position Title: Date:

Page No. Page 4 of 4 PULL-OUT AND TRANSFER TO Form No. GLDD - 981 SUPPLIER OF GAMING EQUIPMENT Revision NOTIFICATION FORM 6 No. Effectivity Aug. 20, 2025 Attachment: INVENTORY LIST OF ITEMS FOR PULL-OUT/TRANSFER TO SUPPLIER PAGCOR TAG NO. MANUFACTURER PARTICULARS* SERIAL NO. REMARKS NO. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 *Under particular, please indicate Game Theme, Brand and Model, if applicable.