Application/renewal for the establishment of gaming showroom (For enrolled suppliers only)

Page No. Page 1 of 4 APPLICATION/RENEWAL FOR THE Form No. GLDD - 1562 ESTABLISHMENT OF GAMING SHOWROOM Revision No. 1 (FOR ENROLLED SUPPLIERS) July 12, 2023 Effectivity GLDD Reference No._______________________ Date: ___________________________ New Application Renewal SECTION A. GENERAL INSTRUCTIONS And/or Component And/or 1. Type or print the needed information Parts on the spaces provided. You must provide all required information. Component Otherwise, your application will be returned. Parts 2. Refer to Regulation 7, B-Showroom Guidelines of Suppliers Regulatory Manual Version 3.0. for documentary requirements, distance restriction guidelines, distance measurement and type of showroom location/area. 3. Email the clear scans of duly accomplished form together with the prescribed documentary requirements to gldd_suppliers@ pagcor.ph. 4. Submission of LGU documents is required in this form. Secure and submit LGU document/s as prescribed in Item no. 2 above. 5. Submitted form shall be valid within fifteen (15) days from the date of GLDD’s received advice in item no. 4 above, subject to Applicant’s compliance with the submission of complete documentary requirements. 6. Cut-off for submission of applications shall be 4:00 P.M. Note: for any query regarding your application, you may call tel. no. 8-522-1242 to 45 loc 5006 or send an email to the address above. SECTION B. APPLICATION DETAILS Name of Supplier (please provide complete registered name): _____________________________________________ Showroom Address: _____________________________________________________________________ Email address: _____________________________ Contact No.: _________________________________ Name of Authorized Representative/Designation: ______________________________________________ To be attached: Secretary’s Certificate stating Board’s Resolution in designating the name of the Authorized Representative of the company who will transact with PAGOR and sign documents. Please check type of gaming equipment and/or gaming paraphernalia for exhibit/demo Electronic Gaming Electronic Bingo Traditional Bingo Others Machines and/or Machines and/or Equipment and/or Component Parts Component Parts Component Parts Slot Machines And/or Compone Electronic Table nt Parts And/or Component Parts And/or Component Parts And/or Component Parts Games And/or Component Parts And/or Component Parts

Page No. Page 2 of 4 APPLICATION/RENEWAL FOR THE Form No. GLDD - 1562 ESTABLISHMENT OF GAMING SHOWROOM Revision No. 1 (FOR ENROLLED SUPPLIERS) July 12, 2023 Effectivity SECTION C: SHOWROOM REQUIREMENTS I. Documentary Requirements Submitted Yes No 1. Company profile. 2. Details and location sketch of the showroom venue. 3. Registration Certificate from Securities and Exchange Commission (SEC). 4. Articles of Incorporation and by-laws approved by the SEC. 5. Latest General Information Sheet (GIS) duly filed with SEC. 6. Mayor’s Permit or relevant business permit for the location of showroom. 7. Registration Certificate from the original location of the company office. 8. Proof of ownership or Contract of Lease for the proposed showroom. 9. List of products to be showcased. 10. Supporting document, if located within Clark Special Economic Zone (as applicable) (To be accomplished by GLDD) II. Compliance of Gaming Showroom to Showroom Area Requirements List of PAGCOR Authorized casinos and VIP Club (Two [2] kilometer-radius within the showroom location) 1. __________________________________________________ 2. __________________________________________________ 3. __________________________________________________ 4. __________________________________________________ 5. __________________________________________________

Page No. Page 3 of 4 APPLICATION/RENEWAL FOR THE Form No. GLDD - 1562 ESTABLISHMENT OF GAMING SHOWROOM Revision No. 1 (FOR ENROLLED SUPPLIERS) July 12, 2023 Effectivity SECTION D: DECLARATION By signing below, we declare that: 1. The information contained in this application including all documents submitted relative to this application are valid, true and correct; 2. We understand that at this point, PAGCOR does not require any contractual agreement for the establishment of gaming showroom. Only in the event of PAGCOR’s written approval of the establishment of Gaming Showroom thereat shall we execute and submit such agreement and likewise commence with the renovation of the venue. We will not hold PAGCOR liable for any rental/construction expenses that we may incur relative thereto, 3. We understand that submission of LGU document/s is a requirement in this form of the application, i.e. we are required to secure LGU documents or as advised by PAGCOR. 4. We have executed this statement with the knowledge that misrepresentation or failure to reveal information requested maybe deemed sufficient cause for disapproval/denial of this application or revocation of the Supplier Showroom Permit if application has been approved by the time such misrepresentation or act of omission is discovered. 5. We are certifying that the gaming showroom is compliant with the Local Government Unit’s requirements and regulations on putting up of this type of establishment and that we will not hold PAGCOR liable for expenses brought about by closure orders and/or penalties incurred should venue be found non-compliant with LGU regulation. Printed Name: _____________________________ Signature: ___________________ (Authorized Representative) Position Title: _____________________________ Date: ___________________ SECTION E. EVALUATION (To be accomplished by GLDD) 1. Gaming showroom is acceptable in terms of distance and requirements (as declared by applicant); Acceptability of this showroom is not a guarantee of the approval of this application. The grant of the Supplier Showroom Permit is subject to the PAGCOR Board’s approval. Incomplete documents/ non-compliance with the requirements for the establishment of 2. gaming showroom will not be received by GLDD for processing. GLDD Evaluator Date

Page No. Page 4 of 4 APPLICATION/RENEWAL FOR THE Form No. GLDD - 1562 ESTABLISHMENT OF GAMING SHOWROOM Revision No. 1 (FOR ENROLLED SUPPLIERS) July 12, 2023 Effectivity 3. Proposed Showroom venue is unacceptable due to: violation of distance requirement/s the applicant is not enrolled with GLDD non-payment of the non-refundable application fee GLDD Evaluator Date Once the application is approved, GLDD shall inform the Supplier of such approval and shall subsequently issue the Supplier Showroom Permit.