Corrective Action Order Form
LLBC - RP Form 3 Page No. Page 1 of 1 CORRECTIVE ACTION ORDER Form No. GLDD - 1675 Revision No. 0 Effectivity Aug. 13, 2025 Date: RP Docket No: Licensee: Address: Reference: SECTION A. BASIS OF ORDER First-time minor violation involving operational practice Accessory penalty Others: ____________________________________ SECTION B. INSTRUCTION(S) SECTION C. NON-COMPLIANCE WARNING Failure to comply with this Corrective Action Order within the prescribed timeline may result in the imposition of further regulatory sanctions, including but not limited to monetary penalties, suspension of operations, or other regulatory actions deemed appropriate. MA. VINA CLAUDETTE P. OCA Assistant Vice President cc: AVP, CMED-IR ACKNOWLEDGEMENT RECEIPT (To be filled out by the authorized signatory of Licensee/Gaming Operator) By: Printed Name: Signature: Position Title: Date: LLBC - RP Corrective Action Order 1|Page
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