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G&MrilNG trililps &il*s pk&&uHs RH&#H$? &$d&

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{Jse fixs fnxm fo req{resf appfi}yal from PAGCSR of fi:s pr*pmsed gar??ri}S cfitf}$ a*#pfeq**s ** *e srsed lm f&*
poker cie.r&. CInfy requesfs wif& coiyecd'and eonip{efe r*ftrffirafi"o* l*nff &e prccessed. Farfe,rre 9er prowde
cornplefe dscg**:*nfs a*d rnfprm**smm *e*;{d r-esulf m m**-prmessrrug *f *fiis r*quresf" *eJf-sff furs{r&s?ss*ffit?
sna/l i;e 4:AA F.ivi.

PLEASE ALLOW IEN {l9}llUQI.NFq$ DA_yq FROw| THE SrJBNriSSrOr'd CIF C$$.4PLETE INFf}RIVIATION
A$.1{} &?'Td{.;1"{fl'E{::f'j"1-S p*Fl {.il_trffi;g' rR#*ff$$ y*l_JF{ iEtr{,}LrS$T

Name of 0perator; MARLYN M- il,IANGUBAT/ II,IPJ 6ROUP CORPORATION

F*il;*;'illxh S*itt*; trtP*$ifiXt HiJr*
F*ker elulh !-meatioE'l; *85{S[ A[_1ufifi t'tSTr.L, A.* F*ST*r"]A $T&[rT Fi1,{\f{i}&UI f lTY. PHln-tPPlfdf S

ManufacturerlSupplier Nanre : STRHAKS N BEATS INCCIRPORATED

rlff i ** .&i*i..d r *s.s : }3tr3 e{e${{*fif fl$8. s&r,i xs*il\${#, {iTY. $*&ru*Le

Up*rator'e irr{ended use fCIr the ehips/ptaq*.r'es: F#ffi p*Htrffi &iitsHs

SEGTION A: tsETAlLS OF PROPOSED GAnfilNG GFIIPS AfrID PLAQUES lrosrpRcyrDEDByopERA,-GR)

Proposed gaming chips and plaques with corresponding artworks attaehed as Annex AEg!H:!'5Ar'lDPl-AQuEs
{Check app*icah&e box hel*w}:
*/
[S rnltaurf&ragfrma$ proposal r_r
[_! mn**t*tcati*ms to previous apprewad

This is also to certify and confirm that the initial/original artworks or modifications ta the artworks for
betlt gan*ing clrips a*d pilaqu*s, whiqh ane dravrn t* *e**al siee *r *arg*r ira s*aie are c*rss{stemt wtt}*
PAGCOR's requirements and indicates, at a minimum, the following:
i " h{easurernent of thickness, Sian"*et*r ff*r chEps} a*d te*gth of sides {t*r pkques};
2" Exact color and design of each face and edge of the chlp and plaque;
S" Security {eatures cont*in*d on the cBrip or p**qt*e;
4. Narne af issuing pcker club ruarked cn each face; and
5. Value *f the chip or plaque rnarked ssr ea*h face.
The {uliowing t3r:cul-r'rentg are tn be su&rrnitted afit*g w}ttt this apptiea{iott:

a) Frsm the ehiplPlaque Ualufacturef

1. A certification under oath or notarized affirmation, executed hy its authorized signat*ry" that it has
a lq*rltten systenr *{ i*ternmi **rntr*t that desmihes im detsil the curnec}t *dr*i*i tratiw*, a*c**"*rtti*g
and security procedures which are utilized in the manufacture, storage and shiprnent cf the gaming
ehips, p{aqu*x a*d related mater"im*s.

2. A copy CIt ttie wrttten interna{ emattrsi systern Et ernp*oy*, w$tiah stt*}i tftck$de mt a rfii*tir*s.t{rl, &
detailed, narrative de*criptior': *f the pr**edxr*s and c**tr*{s *ra'*pler*ented tm sn$Hre the !*tegrit5*
and security sf the manufaeturing prscess, frem design through shipment.
 GL$t) Refer*n*e Sm,r

h ) F--r-*p"m-i{&$pemisr
1- A ce*ification stating that it I'ras conducted due ditigence on and ie satisfied with ttie garning
*$:iplp{mque rvra*ufmcturer'* syster:r sf imternaf e*r"ctre}.

2- The internal control procedur*s it plans t* rnak* use *f docurnenting the distribution, redemption,
re**lpt *n*i i*ve*t*ry *.f gamir:g ehips mnt$ pfaqt,*es.

This is also to certify that the above proposatrs on gaming chip* and plaques are ccnsistent witlt
Hegulaticn S Seeti*yrs *, 2 amd S *t t*re Garvting Sit* ffiegutat*-ry M*nua* {Fak*r Gxm"l*s}"

Authorized Signatory: IV1ARLYN fiN. fvl AI{6 [J BAT Signature

{:*si:{i** Tit!;* . l;frff5ii.i[.fiiT *;rtc,: ]*rs
SHCTIOH B: $UBMI$SISN INSTRUCTIOf{
Crise $sctiun A is uumpleted, piease sr.;bmiit this forrn ts Gltii eionE l-ritfi tht attachffTents, F{ard
*opie* m*y be subr"rtitted direct*y tc th* GLn* *ffice qx ssanraed coples sf ttt* d*sffrft*$ts r*ay he er*al!*d
using the e-mailaddresses indicated below:
Gaining l-icemsing emd Eeveiopnnent Eepartifi erit
PhitiBpine Arnu*s*ment and Gami*g C*r:porati*m
3'd Ftsor PAGCOR t-lguse, 1330 Roxas Bsulevard, Ermita, Manila
Tel" tr$cs" 52?-348S 152'1-'!543 $s*. S8,5

E-mail address. gldd.rgucnmpliance@pagcor"ph

Sff*TIf}f* *: ,&fiT!*S{ T,&Kffi&! i.iij,*::: ,i::ji-i;,:j i:;i: ro" i:;t_aiil,

Proposed qaming chips and plaeues is/are

A. RETURNES d*e tn ins*fficient details anrJl*r incnr-':rp!*te d*curn*nt*ti*n

m S" HffifiE;lV** F{"}B pR**m$$qf-*ffi,srth es*i*r:sC &ffiF*ffiH*Jfiffi ${{}"

By: Frinted Narne: Signature:
Fositrog'1 Titfle: *at*:

il] fr. RH6ffifi#ffiHf\fiffi&Yffffiru F8R ePPKS\feL suto$ect te Sperat*r's submissioct ts GLDry of $*:iprrerd
Ctearan*e Request *r"rd Appr*va{ F*rnr *r Trartsfer *f Gan:lng Eq**ipmer*t f.{cfifr**f!*n F*n*t
covering the impartation or local purcfiase sf said gaming cfuips and p*aques.

Ey: Frinted Name: Signature

Ft:siti*ft Title: *at*:

Approved by:

RAMON STEFHEN R. VILLAFLOR

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