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PHOTOGRAPH AND
VIDEO COVERAGE Form No. GLDD-941

NOTIFICATION FORM Rev. No. 0

Effectivity Sept. 01, 2019

GS Form No. 34 GLDD Reference No.: _________________

Use this form to notify Gaming Licensing and Development Department (GLDD) regarding photograph and video
coverage inside the gaming site or poker club premises. Please accomplish this form by providing correct and
complete information. The Operator shall submit this form to GLDD at least two (2) business days prior to intended
date of implementation. Cut-off for submission of notifications shall be 4:00 P.M.

PLEASE NOTE THAT PAGCOR RESERVES THE RIGHT TO CONDUCT POST-AUDIT OF THE
PHOTOGRAPH AND VIDEO COVERAGE TAKEN INSIDE THE GAMING SITE/POKER CLUB PREMISES.
Name of Operator: ___________________________________________________________
(please provide complete registered name)
Gaming Site/Poker Club Name: ___________________________________________________________
Gaming Site/Poker Club Location: ___________________________________________________________
(as reflected in the license)
Date of Photograph and/or Video Coverage: _______________________________
Purpose: ___________________________________________________________
___________________________________________________________
SECTION A: PHOTOGRAPH AND VIDEO COVERAGE (TO BE PROVIDED BY OPERATOR)
Please be informed of the photograph and video coverage to be conducted inside the gaming site/poker club premises
particularly in the following locations:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
We confirm and undertake to do the following:
 There will be no tri-media coverage or documentation of poker cash games and/or actual live gaming operations,
i.e. customers playing on gaming terminals and/or tables.
 For promotional purposes, photo and/or video coverage shall be allowed purely on “mock-up/production set-up”
where actors/actresses portray gaming site customers playing on gaming terminals and/or tables. The gaming
terminals shall not be in play during the shoot.
 Should tournament (i.e. poker, electronic slots, etc.) photos or videos be warranted, players will sign waivers that
they agree to include their faces in the documentation of the photograph/video recording event.
 When shooting photos or videos of non-gaming events inside the gaming site/poker club (e.g., documentaries, et.
al.), camera(s) shall not be allowed to focus at or point in the general direction of the gaming terminal and/or
gaming table areas.
 The use of camera/s other than that of the Operator or its authorized photographer/videographer shall be
prohibited.
 The photo and/or video coverage shall not cause any disruption to gaming site/poker club operations.
 PAGCOR reserves the right to prohibit the commercial use of any photograph or video footage taken during the
shoot as it deems warranted.
 Use of any photograph or video footage as advertising material shall be in accordance with Section VII of
PAGCOR’s Responsible Gaming (RG) Code of Practice and any applicable RG circular which can be viewed
respectively at “Responsible Gaming” and “Announcements” links at www.pagcor.ph/regulatory/index.php.

Printed Name: _____________________________________ Signature: _______________

(Authorized Representative)
Position Title: _____________________________________ Date: _______________

SECTION B: SUBMISSION INSTRUCTIONS

Once Section A is completed, please submit/mail/e-mail this form to GLDD together with supporting documents to the
address/e-mail addresses indicated below:
Gaming Licensing and Development Department
Philippine Amusement and Gaming Corporation
PAGCOR Main Corporate Office, 12th Floor, iMET BPO Tower,
CBP-1A Metropolitan Park, Roxas Boulevard, Pasay City
Tel. Nos. 755-3199/755-3299/755-3899/755-3999 loc. 5012, 5013, 5084 and 5085
E-mail address: GLDD.RGUCompliance@pagcor.ph

SECTION C: ACKNOWLEDGEMENT/REJECTION OF NOTIFICATION (TO BE FILLED UP BY GLDD)

 RECEIVED with REFERENCE NO. _________________

By: Printed Name: _____________________________________ Signature: _______________

Position Title: _____________________________________ Date: _______________