Certificate of Destruction of Gaming Machines

Page No. Page 1 of 2 CERTIFICATE OF DESTRUCTION Form No. GLDD - 742 OF GAMING MACHINES Revision 0 (FOR SUPPLIERS USE ONLY) No. Effectivity September 7, 2023 The Supplier shall accomplish this form following the conduct of permanent destruction of gaming machines. Once completed, a copy of this form shall be furnished by the Supplier to each of the following: (a) Compliance Monitoring and Enforcemenmt Department (CMED); (b) Gaming Licensing and Development Department (GLDD); and (c) Bureau of Customs (BOC). The Supplier shall provide BOC photos of the destruction process, copies of which shall also be provided to CMED and GLDD, when requested. Name of Supplier: Date: Warehouse Address: Date of Destruction: ____________________ Approved per GLDD Reference No.:__________________ Location of Destruction ________________________________________________________________ SECTION A: LIST OF DESTROYED GAMING MACHINES (To be filled up by the Supplier) I. A. DETAILS OF GAMING MACHINES (EGM and/or EBM) Please be informed of the destruction of the following gaming machines: ITEM MANUFACTURING PAGCOR EGM / EGM SERIAL NO. MANUFACTURER GAME THEME PLATE NO. QUANTITY INVENTORY TAG NO.(If available) NO. 1 2 3 4 5 6 7 8 9 10 [This covers ten (10) gaming machines only. Use additional form for another set of EGMs/EBMs] Attachment: Duly accomplished Form No. ___Destruction of Gaming Equipment and/or Paraphernalia Request and Approval Form and Inventory checklist of EGMs and EBMs for destruction. We affirm and certify that the abovementioned gaming machines are permanently destroyed and are incapable of being used. Once these items are found to be used illegally, the Supplier shall be held liable to PAGCOR. Destruction performed by: Witnessed by: Supplier’s Authorized Representatives: PAGCOR Team Representatives: Printed Name and Signature, Designation Printed Name and Signature, Designation Printed Name and Signature, Designation Printed Name and Signature, Designation

Page No. Page 2 of 2 CERTIFICATE OF DESTRUCTION Form No. GLDD - 742 OF GAMING MACHINES Revision 0 (FOR SUPPLIERS USE ONLY) No. Effectivity September 7, 2023 SECTION B: ELECTRONIC GAMING MACHINES DESTRUCTION REPORT We hereby certify that the destruction of the aforementioned gaming machines were done in accordance with the guidelines prescribed in Regulatory Framewaork for Destruction of Gaming Equipment and Gaming Paraphernalia (Regulation) on___________________ at ________________. (DATE) (VENUE) By: Bureau of Customs (BOC) Representatives 1 Name: Signature: Designation: 2 Name: Signature: Designation: 3 Name: Signature: Designation: 4 Name: Signature: Designation: