Cmed Ir 473 Break Seal And Seal Back

Page No. Page 1 of __ Form No. CMED IR-473 BREAK SEAL AND SEAL BACK Revision No.: 1 Effectivity July 12, 2023 Gaming Equipment: SM ETG Controller Server Shaker Others: Action to be taken: For RAM Clear No RAM Clear / For Repair For Replacement Purpose: Job Order #: Please specify the reason e.g. for movement, change in parameter settings, conversion, cessation, RAM corrupted etc., MACHINE DETAILS BREAK SEAL SEAL BACK LOCATION SM/ASSET NO. / MACHINE ID MACHINE SERIAL NO. MANUFACTURER GAME THEME / NAME GAME TYPE DENOMINATION SEAL NUMBER RTP% MACHINE METERS TURNOVER / COIN-IN APPROVED PAYOUT / COIN-OUT JACKPOT TABLE DETAILS FOR DICE SHAKER BREAK SEAL OF SHAKER SEAL BACK OF SHAKER GAMING TABLE NUMBER: Old Seal No.: New Seal No.: PREPARED AND VERIFIED BY: TIME DATE LICENSEE TECHNICIAN SM/EG AMBASSADOR / TG DEALER SM/EG/TG SUPERVISOR SM/EG/TG O/MANAGER WITNESSED BY: LICENSEE SURVEILLANCE LICENSEE SECURITY CMA I/II, PAGCOR MONITORING TEAM REMARKS NOTED BY: CMEO I/II, PAGCOR MONITORING TEAM