Quarterly Log Report Format

Page No. Page 1 of 1 Form No. GLDD – 1017 QUARTERLY LOG REPORT FORMAT Revision No. 3 Effectivity July 12, 2023 Supplier’s Name: Storage Facility Location: Storage Facility Administrator: Period Covered: January – March April – June July - September Use this form to log all the activities of the gaming equipment and paraphernalia stored at the Registered Supplier’s storage facility. This form should be submitted to GLDD not later than the 10t h day of the succeeding quarter month (i.e., April, July and October). EGM Spare parts for may not be included in the inventory. Use additional sheets if necessary. MOVEMENT PAGCOR MANUFACTU DATE OF MANUFACTURER’ TYPE OF (Please fill out the applicable column only) INVENTO RER STORAGE RY TAG S SERIAL EQUIPMENT DESCRIPTION NUMBER DATE DATE LAST NUMBER DATE OF SHIPPED PULLED LOCATION IMPORTATION OUT OUT INSTALLED