1.18 CERTIFICATE OF GAMING EQUIPMENT/ PARAPHERNALIA DESTRUCTION FORM

CERTIFICATE OF Page No. Page 1 of 2 GAMING EQUIPMENT/ Form No. EGLD - 430 PARAPHERNALIA Rev. No. 4 DESTRUCTION FORM Effectivity July 13, 2026 EG Form No. 23 CMED Reference No.: _______________________ Entity Classification: Gaming Venue Operator (Operator) Game Content Provider (GCP) Name of Operator / GCP: ________________________________________________________________________ (As reflected in the license / accreditation certificate) Gaming Venue / Live Gaming Studio Set-Up: _________________________________________________________________________________________________ (As reflected in the license / PTH Certificate) Gaming License/Accreditation No.: ____________________ PTH No (For GCP) : _______________________________ Type of Game Offering: ___________________________________________________________________________ Location of Destruction of Gaming Equipment/Paraphernalia: ______________________________________________ Date of Destruction of Gaming Equipment/Paraphernalia: _________________________________________________ Notified using EG Form No. 22 with CMED Reference No. _______________________________________ Use this form after destruction of gaming equipment/paraphernalia has been completed. Use additional form for another set of gaming equipment/paraphernalia. An Operator whose license has been revoked, or a GCP whose accreditation and/or PTH has been cancelled, shall dispose of its gaming equipment and/or paraphernalia within ninety (90) calendar days from the date of the revocation of its license or the cancellation of its accreditation and/or PTH. LIST OF GAMING / PARAPHERNALIA FOR DESTRUCTION ITEM DESCRIPTION MODEL/CODE QUANTITY NO. (Name of Supplier, Size, Shape, Colors, etc.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (Please use separate sheet if necessary) We affirm, declare and certify that the abovementioned gaming equipment/paraphernalia are permanently destroyed and rendered unusable for gaming operations. We are aware that should these gaming equipment/paraphernalia are found to be operating illegally (for operational gaming venues / live gaming studio set-up) or found under our possession, whether declared destroyed, sold, shipped out or otherwise, after the ninety (90)-day disposal period (for gaming venues with revoked Licenses / GCP with cancelled accreditation and/or cancelled PTH), we may be held criminally liable under Philippine laws. __________________________________________________ ________________________________ Printed Name and Signature of Operator / GCP Date or Authorized Representative, Designation

CERTIFICATE OF Page No. Page 2 of 2 GAMING EQUIPMENT/ Form No. EGLD - 430 PARAPHERNALIA Rev. No. 4 DESTRUCTION FORM Effectivity July 13, 2026 REPUBLIC OF THE PHILIPPINES ) CITY/ MUNICIPALITY OF ) S.S. I, after being duly sworn to in accordance with law, hereby depose and state, that the above certification, including declarations therein, affirming the destruction of above-listed gaming equipment/ paraphernalia is true and correct. Signature of Operator / GCP / Authorized Representative Government Issued ID: ID No.: Date Issued: SUBSCRIBED AND SWORN to before me this day of , 20 , in the City/ Municipality of , affiant exhibiting to me the above-stated government-issued identification card. (Notary Public) Doc. No. Page No. Book No. Series of 20