2.3 Report on Gross Gaming Revenue and PAGCOR Share for Electronic Bingo

Operator: Bingo Gaming Site: Bingo Gaming Site Location: Period Covered: WEEKLY REPORT ON GROSS GAMING REVENUE AND PAGCOR SHARE (ELECTRONIC BINGO)

DATE Total Collection (Collection + Overage) a Totai Payout Unciaimed) (Payout - b Revenue(GGR) Gross Gaming C=(a-b} Franchise Tax (2.5% of GGR) d = c*0.025 PAGCOR Share (50% of GGR) e = c*0.50 (d+e Total

K B WE

3 E K E Sub-Total PO.00 PO.00 PO.00 PO.00 PO.00 PO.00

Sub-Total P0.00 PO.00 PO.00 PO.00 PO.00 PO.00 W E E Y

Sub-Total PO.00 PO.00 PO.00O PO.00 PO.00 PO.00

3 E E K

4

Sub-Total P0.00 PO.00 PO.00 P0.00 P0.00 PO.00

k W E E

TOTAL Sub-Total PO.00 P0.00 PO.00 PO.00 * PO.00 PO.00

Pagcor Share Offsetting + FT from Previous Month Overl(Short) Week 1 Week 2 Week 3 Week 4 Week 5

Amount Due to Pagcor PO.00 PO.00 PO.00 PO.00 PO.00

Note: Any adjustments for the previous week should already be reflected on the latest report Submitted by: Checked/ Verified by:

BINGO GAMING SITE REPRESENTATIVE (Signature Over Printed Name) (Signature Over Printed Name) PAGCOR REPRESENTATIVE