1.19 CHANGE IN GAMING SITE OPERATING HOURS NOTIFICATION FORM

Page No. Page 1 of 1 CHANGE IN GAMING SITE OPERATING HOURS Form No. EGLD - 431 NOTIFICATION FORM Rev. No. 4 Effectivity August 17, 2023 GS Form No. 24 CMED Reference No.: _________________ Use this form to notify Compliance Monitoring and Enforcement Department (CMED) regarding change in daily operating hours or change in operating hours due to holiday/s of the gaming site. Please accomplish this form by providing correct and complete information. The Operator shall submit this form to CMED at least one (1) business day prior to intended date of implementation. Cut-off for submission of notifications shall be 4:00 P.M. PLEASE NOTE THAT PAGCOR RESERVES THE RIGHT TO CONDUCT POST-AUDIT ON THE CHANGE IN OPERATING HOURS OF THE GAMING SITE. Name of Operator: ______________________________________________________________________ (As reflected in the license) Gaming Site Location: ______________________________________________________________________ (As reflected in the license) Type of Game Offering: _____________________________ GL No.: _____________________ SECTION A: REQUEST DETAILS (TO BE PROVIDED BY OPERATOR)  A. Change in Daily Operating Hours From: ________________ To: ________________ Implementation Dates: ________________________  B. Change in Operating Hours Due to Holiday/s - From: ________________ To: ________________ Implementation Dates: ________________________ Name of Holiday/s: ___________________________________________________________________ Reason/s: ___________________________________________________________________ ___________________________________________________________________ By: Printed Name: _________________________________ Signature: _______________ Position Title: _________________________________ Date: _______________ SECTION B: SUBMISSION INSTRUCTIONS Once Section A is completed, please submit this form to CMED. Hard copies may be submitted directly to CMED office or scanned copies of the documents may be emailed using the e-mail addresses indicated below: Compliance Monitoring and Enforcement Department E-mail addresses: Philippine Amusement and Gaming Corporation NCR & Luzon – [email protected] PAGCOR Main Corporate Office, 12th Floor, iMET BPO Towe Visayas – [email protected] CBP-1A Metropolitan Park, Roxas Boulevard, Pasay City 1300 Mindanao – [email protected] Tel. Nos. (+632) 8522-0299 / 8522-1357 / 8522-1245 / 8522-1324 E-mail address: Local 5186 (Bingo Games) Local 2404 (Electronic Games) - [email protected] If submission of this notification form is done thru e-mail, the Operator should ensure that it has been duly received and acknowledged by CMED. The Operator shall be notified thru e-mail confirming receipt of this notification form. If no e-mail confirmation is received, the Operator should submit the hard copy of the notification form directly to CMED. SECTION C: ACKNOWLEDGEMENT OF NOTIFICATION (TO BE FILLED UP BY CMED)  RECEIVED with REFERENCE NO.: _________________ By: Printed Name: _________________________________ Signature: _____________ Position Title: _________________________________ Date: _____________