Pullout and Transfer of Gaming Equipment and Gaming Paraphernalia Notification Form

Page No. Page 1 of 4 PULL-OUT AND TRANSFER OF GAMING Form No. GLDD-1014 EQUIPMENT AND GAMING PARAPHERNALIA NOTIFICATION FORM Revision No. 6 Effectivity Feb. 25, 2026 Use this form to notify GLDD with regard to the pullout and transfer of gaming equipment and/or gaming paraphernalia to and from the Supplier’s storage facility. Please provide correct and complete information. Submit this form to GLDD at least two (2) business days prior to the intended date of transfer. PLEASE NOTE THAT PAGCOR RESERVES THE RIGHT TO CONDUCT POST-AUDIT OF ALL GAMING EQUIPMENT AND GAMING PARAPHERNALIA STORED IN THE REGISTERED SUPPLIER’S STORAGE FACILITY. Name of Supplier: Date: Permit No.: Permit Validity: Storage Facility Address: Date of Implementation: SECTION A: TRANSFER OF GAMING EQUIPMENT (TO BE PROVIDED BY THE SUPPLIER) Type of gaming equipment or gaming paraphernalia for pullout and transfer: Gaming Table Bingo machine or console Playing Cards Chips/Plaques Slot Machine Spare parts/ Accessories Game Conversion kits Gaming Table Layout Signages Surveillance Equipment Casino Management System for Tables, Slots or E-bingo Gaming Paraphernalia Bingo Flashboard Slot Machine Bingo Paraphernalia Electronic Table Game Terminals Bingo Tickets Electronic Bingo Machine/ Terminal Bingo Balls Others ___________________ Attachment: Inventory List of Items for Pullout and Transfer Description of subject item(s): Please mark the applicable box: A. TRANSFER OF GAMING EQUIPMENT OR GAMING PARAPHERNALIA FROM A GAMING ESTABLISHMENT TO THE SUPPLIER’S STORAGE FACILITY Operator: Gaming Establishment Address: Reason for Pullout and Transfer:

Page No. Page 2 of 4 PULL-OUT AND TRANSFER OF GAMING Form No. GLDD-1014 EQUIPMENT AND GAMING PARAPHERNALIA NOTIFICATION FORM Revision No. 6 Effectivity Feb. 25, 2026 B. TRANSFER OF GAMING EQUIPMENT OR GAMING PARAPHERNALIA FROM THE SUPPLIER’S STORAGE FACILITY TO A GAMING ESTABLISHMENT Operator: Gaming Establishment Address: Reason for Pullout and Transfer: C. TRANSFER OF GAMING EQUIPMENT OR GAMING PARAPHERNALIA FROM ONE STORAGE FACILITY TO ANOTHER Name of Supplier (Transferee): Permit No. Validity: Storage Facility Address: Reason for Pullout and Transfer: ___________________________________________________ We confirm and undertake that the conduct of pullout and transfer of the gaming equipment and/or gaming paraphernalia is compliant with the requirements set forth in Regulation 5 of the Suppliers Regulatory Manual. Name of Supplier’s Authorized Representative: Position Title: Signature: Date: SECTION B: CONFIRMATION OF ACCOUNTABILITY (TO BE ACCOMPLISHED BY THE RECIPIENT OF TRANSFERRED ITEMS) We hereby confirm that we shall ASSUME THE FULL RESPONSIBILITY AND ACCOUNTABILITY of the abovementioned item/s transferred to us. Further, our storage facility/gaming establishment is available to PAGCOR for inspection of gaming equipment and gaming paraphernalia at any time, that may be deemed necessary by PAGCOR. By: Recipient’s Authorized Signatory Date (Signature Over Printed Name)

Page No. Page 3 of 4 PULL-OUT AND TRANSFER OF GAMING Form No. GLDD-1014 EQUIPMENT AND GAMING PARAPHERNALIA NOTIFICATION FORM Revision No. 6 Effectivity Feb. 25, 2026 SECTION C: SUBMISSION INSTRUCTIONS Once Sections A and B are completed, please submit this form to GLDD together with the supporting pull- out documents: Gaming Licensing and Development Department Philippine Amusement and Gaming Corporation MET Live Building, Central Business Park 1-A Macapagal Boulevard corner EDSA Extension, Pasay City 1300 Tel Nos. (02) 8522-0299 local 1156 OR you may send a scanned copy of this form together with the necessary attachments via email to: [email protected] If submission of this notification form is done thru e-mail, the Supplier should ensure that it has been duly received and acknowledged by GLDD. If no acknowledgement email is received from GLDD a day after the notification form is submitted, the registered supplier should inquire directly with GLDD. SECTION D: ACKNOWLEDGEMENT OF NOTIFICATION (TO BE ACCOMPLISHED BY GLDD) RECEIVED with Reference No. Signature: By: Printed Name: Date: Position Title:

Page No. Page 4 of 4 PULL-OUT AND TRANSFER OF GAMING Form No. GLDD-1014 EQUIPMENT AND GAMING PARAPHERNALIA NOTIFICATION FORM Revision No. 6 Effectivity Feb. 25, 2026 ATTACHMENT: INVENTORY LIST OF ITEMS FOR PULLOUT/TRANSFER PAGCOR No. Items to be Quantity Manufacturer Particulars* Serial No. Inventory Remarks Transferred Tag 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.