Gs Form. No. 3 - Request For Renewal Of Gaming License Form printable pdf download

GS Form. No. 3

(v.1.1) 05.25.2016

Philippine Amusement and Gaming Corporation

Gaming Licensing and Development Department

PAGCOR House, 1330 Roxas Boulevard, Ermita, Manila

REQUEST FOR RENEWAL OF GAMING LICENSE FORM

GENERAL INSTRUCTIONS

1. Use this form if Operator intends to renew its Gaming License.

2. Type or print the needed information on the spaces provided. The Operator must provide all required

information. Incomplete requirements will cause the non-renewal of the Gaming License which will be

subject to the guidelines on revocation of the same as defined in Regulation 6 of the Gaming Site

Regulatory Manual.

3. Please accomplish and submit this form no later than the third (3rd) week of the preceeding month of

the Gaming License expiration month, together with the prescribed documentary requirements, to:

Gaming Licensing and Development Department (GLDD)

Room 314, 3rd Floor PAGCOR House

1330 Roxas Boulevard, Ermita, Manila

Attention:

Noel Eugenio P. Cuenca

Senior Regulatory Officer

or email to

gldd.rgulicensing@pagcor.ph

gldd_ebingo@pagcor.ph

3. Please use the Payment Processing Request Form (GS Form No. 2) for payment of the Renewal Fee

and/or fines for demerits incurred during the current License period.

4. Cut-off for submission of requests shall be 4:00 P.M.

1. Name of Operator:

(If Operator is a corporation, partnership or other business entity, please provide full registered name.)

2. Gaming Activity:

PeGS

InstaWin

Xchangebet

Electronic Games:

Traditional Bingo

eBingo

Bingo Games:

MSW Sports Betting

Poker Club

Other Games:

3. Gaming Site Address:

4. Validity of Gaming License (GL)*:

From: _________________

To: _________________

*shall apply to COR as needed

5. With more than one (1) Gaming Site?

Yes

If yes, please indicate Gaming Site/s:

Gaming Site

Address

Gs Form. No. 3 - Request For Renewal Of Gaming License Form

Related Articles

Related Categories