1.25 CLOSING INVENTORY LIST OF GAMING EQUIPMENT AND PARAPHERNALIA FORM - CHANGE IN OPERATOR

CLOSING INVENTORY LIST OF Page No. Page 1 of 3 GAMING EQUIPMENT AND Form No. EGLD - 1490 PARAPHERNALIA FORM Rev. No. 0 CHANGE IN OPERATOR Effectivity June 25, 2025 EG Form No. 32 EGLD Reference No.: Please use this form to submit to EGLD the closing inventory of all the gaming equipment and paraphernalia currently located in the gaming venue, prior to the assumption of operations by the New Operator. Kindly accomplish this form providing correct and complete information. This document shall be part of the requirements for the application for amendment of gaming license due to Change in Operator. SECTION A: DETAILS OF THE OPERATOR 1.Name of Existing Operator: ________________________________________________________________ (as reflected in the license) 2.Gaming Venue Address: ________________________________________________________________ (as reflected in the license) 3.Game Offering: ________________________________________________________________________ Brand/s: __________________________________________________________________________ Gaming System Administrator/s (If any): _________________________________________________ 4. Gaming License No.: ____________________________ Gaming License Validity: ____________________ SECTION B: LIST OF GAMING EQUIPMENT/ PARAPHERNALIA ITEM TYPE OF EQUIPMENT PARTICULARS SERIAL PAGCOR TAG NO. /PARAPHERNALIA (SUPPLIER/ NUMBER NO. MANUFACTURER) 1 2 3 4 5 6 7 8 (For additional list of equipment/paraphernalia, please use Schedule I) We affirm, declare, and certify that the above-listed items, including those listed in Schedule I (if any), constitute the complete inventory of all gaming equipment and paraphernalia currently located in our gaming venue prior to the assumption of operations by the new/incoming operator. We are aware that the above-listed items shall be turned over by the existing operator to the new/incoming operator upon receipt of EGLD notice granting the latter authority to assume management of the above gaming venue. We are aware that should any of the above-listed items be found in the possession of the existing operator after the 90-day disposal period, without justifiable cause or prior approval from PAGCOR, we may be held criminally liable under the Philippine laws. Printed Name: ______________________________ Printed Name: _____________________________ & Signature (Authorized signatory) & Signature (Authorized signatory) Existing Operator New / Incoming Operator Position Title: _______________________________ Position Title: __________________________ Date: _______________________________ Date: __________________________________

CLOSING INVENTORY LIST OF Page No. Page 2 of 3 GAMING EQUIPMENT AND Form No. EGLD - 1490 PARAPHERNALIA FORM Rev. No. 0 CHANGE IN OPERATOR Effectivity June 25, 2025 EG Form No. 32 EGLD Reference No.: ________________ This is to certify that we have verified the inventory of the above-listed items and the same constitute the complete inventory of all gaming equipment/paraphernalia of the above gaming venue. Printed Name: Signature: _________________________ (CMED’s Representative) Position Title _____________________________________ Date. ____________________ ACKNOWLEDGEMENT / REJECTION OF NOTIFICATION (TO BE FILLED UP BY EGLD) Printed Name: Signature: _________________________ (Authorized Representative) Position Title _____________________________________ Date. ____________________

CLOSING INVENTORY LIST OF Page No. Page 3 of 3 GAMING EQUIPMENT AND Form No. EGLD - 1490 PARAPHERNALIA FORM Rev. No. 0 CHANGE IN OPERATOR Effectivity June 25, 2025 SCHEDULE I EGLD Reference No.: __________________ LIST OF GAMING EQUIPMENT/ PARAPHERNALIA TYPE OF PARTICULARS ITEM SERIAL PAGCOR TAG NO. EQUIPMENT/ (SUPPLIER/ NO. MANUFACTURER) NUMBER PARAPHERNALIA