Gldd 975 Change In Surveillance Plan Notification Form Crm F14

Page No. Page 1 of 2 CHANGE IN SURVEILLANCE PLAN Form No. GLDD-975 NOTIFICATION FORM Revision No. 7 Effectivity Mar. 02, 2026 CRM Form No. 14 (FOR PAGCOR PRE-APPROVED SURVEILLANCE PLAN ONLY) Use this form to notify PAGCOR regarding change in surveillance plan. Please accomplish this form by providing correct and complete information. The Licensee shall submit this form to GLDD at least three (3) business days prior to intended date of implementation. PLEASE NOTE THAT PAGCOR RESERVES THE RIGHT TO CONDUCT POST-AUDIT OF THE CHANGE IN SURVEILLANCE PLAN. Licensee : Name of Casino : Implementation Date : SECTION A: CHANGE IN SURVEILLANCE PLAN (TO BE FILLED OUT BY LICENSEE) First Submission Second Submission Third Submission Please be informed of the change in surveillance plan with accompanying screenshots and visual presentations indicating how the activities to be monitored by the casino surveillance system may be affected by the proposed change attached as Annex ___. I. Reason for the change(s) in the surveillance plan. II. Areas to be closed while the change(s) are being effected: _____________________________________________ We also confirm that the revised surveillance plan adequately demonstrates that the casino surveillance system satisfies or will satisfy all the performance requirements applicable to it and that these requirements are in conformance with Regulation 7 of the Casino Regulatory Manual for Licensed Land-Based Casinos. Name of Requestor : Signature : Position Title : Date: SECTION B: SUBMISSION INSTRUCTIONS Once Section A is 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. 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 2 of 2 CHANGE IN SURVEILLANCE PLAN Form No. GLDD-975 NOTIFICATION FORM Revision No. 7 Effectivity Mar. 02, 2026 SECTION C: ACKNOWLEDGEMENT OF NOTIFICATION (TO BE FILLED OUT BY GLDD ) RECEIVED with REFERENCE NO. _________________ By: Printed Name: Signature: Position Title: Date: