ON-LINE USER ACCESS CONTROL FORM

Page No. Page 1 of 2 ON-LINE USER ACCESS Form No. EGLD-950 CONTROL FORM Revision No. 0 (Electronic Submission of Annual Documentary Requirements) Effectivity December 16, 2024 CORPORATION NAME: _______________________________________________________ *Note: For users handling multiple corporations with the same Authorized Signatory, please use Schedule 1. Only one (1) user per Corporation is allowed to register. With Schedule 1: ☐ Yes ☐ No User Information Surname: First Name: Middle Name: Designation: Contact No.: Email: Type of Request ☐ New User/Account ☐ Modify Account ☐ Delete/Disable Account Access Rights ☐ User ☐ Reviewer ☐ Approver Access Agreement (Please read before signing) 1. Access account must not be revealed to others or allowed to be used by others. 2. Password must not be inserted into email messages or other forms of electronic communication. 3. Access level account must not be used to breach security permission level or interruptions to the program. Security breaches include, but are not limited to: accessing data of which the employee is not an intended recipient or logging into the program or account that the employee is not authorized to access. 4. Only authorized representative and email address declared in Form No. EGLD-1310 (Authorized Signatory with Specimen Signature and Contact Information) is allowed to be registered. ☐ I have read, understood, and consented to PAGCOR’s Privacy Notice and Privacy Policy. Authorization User: Authorized by: Signature over printed name Signature over printed name Date: Designation: Date: FOR PAGCOR USE ONLY Confirmation Approved access by: Enrolled by: Signature over printed name Signature over printed name Designation: Designation: Date: Date:

Page No. Page 1 of 2 ON-LINE USER ACCESS Form No. EGLD-950 CONTROL FORM Revision No. 0 (Electronic Submission of Annual Documentary Requirements) Effectivity December 16, 2024 Schedule 1 LIST OF CORPORATIONS Use this form for users handling multiple corporations. 1. 2. 3. 4. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. Authorized by: ________________________________ Signature over printed name