SLOT OPERATOR AND MANAGEMENT COMPANY- APPLICATION AND DISCLOSURE

vania

•

SLOT OPERATOR AND MANAGEMENT COMPANY-APPLICATION AND DISCLOSURE INFORMATION FORM

STADIUM CASINO INVESTORS, LLC

E. PRINCIPAL ENTITY FORM

(To BE COMPLETED BY EACH ENTTTY THAT IS A PRINCIPAL IDENTIFIED IN SCHEDULES 10, 10A, 11, 13, 15AND18).

2. APPLICATION AND LICENSING FEES

A. APPUCATION FEES AND INVESTIGATION DEPOSrTS

APPLICATION FEES MUST BE SUBMITTED WITH THE APPLICATION PACKAGE. THESE FEES ARE NON-REFUNDABLE DEPOSITS THAT WILL BE USED BY THE BOARD TO PROCESS AND.INVESTIGATE THE SLOT OPERATOR OR MANAGEMENT COMPANY APPLICAT/T AND THE APPUCANT'S AFFILIATED ENTITIES AND PERSONS FIUNG FORMS AS PART OF THE APPUCATION PACKAGE. APPUCATION FEES MUST BE SUBMITTED FOR EACH APPUCANT. AFFILIATED ENTITY AND PERSON, UNLESS OTHERWISE NOTED.

THERE MAY BE ADDITIONAL COSTS AND EXPENSES INCURRED BY THE BOARD IN PTS PROCESSING AND INVESTIGATION OF THE SLOT OPERATOR OR MANAGEMENT COMPANY APPUCAIiT ANDTHE APPLICANT'S AFFILIATED ENTITIES AND PERSONS. THE SLOT OPERATOR OR MANAGEMENT COMPANY APPLICAhn- MUST REIMBURSE THE BOARD FOR ALL ADDmONAL COSTS AND EXPENSES RELATED TO THE PROCESSING AND IN^^ST1GATI0N OF THEIR APPLICATION PACKAGE.

SLOT OPERATOR OR MANAGEMENT COMPANY APPUCANT $5,000.00

APPUCANT'S AFFILIATED ENTITIES 32,500.00

PRINCIPAL/KEY EMPLOYEES $2,500.00

PRINCIPAL ENTITY $2,500.00

B. LICENSING FEES

LICENSING FEES MUST BE PAID PRIOR TO ISSUANCE OF THE LICENSE.

CATEGORY 1 SLOT MACHINE LICENSE $50,000,000.00



CATEGORY 1 OR 2 MANAGEMENT COMPANY LICENSE $1,500,000/3 YEAR UCENSE

CATEGORY 3 MANAGEMENT COMPANY LICENSE $150,000/3 YEAR UCENSE

3. APPLICATION FORM INSTRUCTIONS

GENERALLY

AS USED IN THE SLOT OPERATOR OR MANAGEMENT COMPANY FORM, THE WORDS RAPPLICANT" AND "YOU' SHAJ-L MEAN THE SLOT OPERATOR OR MANAGEMENT COMPANY APPUCANT. WHEN APPUCANT'S AFFILIATED ENTMES ARE COMPLETING THE FORM, "APPLICANT' AND "YOU" SHALL REFER TO THE AFFILIATED ENTITY COMPLETING THE FORM.

A L L ENTRIES ON THE FORM MUST BE TYPED OR PRINTED IN BLOCK LETTERING. INITIALS AND SIGNATURES MUST BE HANDWRITTEN BY THE PERSON PROVIDING THE INFORMATION. IF THE ANSWERS ARE NOT LEGIBLE, THE APPUCATION MAY NOT BE ACCEPTED.

PGCB-CA-0912 - Initials

READ EACH QUESTION CAREFULLY PRIOR TO ANSWERING. ANSWER EVERY QUESTION COMPLETELY. Do

NOT LEAVE BLANK,SPACES. IF A QUESTION DOES NOT APPLY TO THE APPLICANT, WRITE "DOES N o t APPLY" IN RESPONSE TO THAT QUESTION. IF A SCHEDULE OR ADDENDUM DOES NOT APPLY TO THE

APPLICANT, WRITE "DOES NOT APPLY" ON THE SCHEDULE OR ADDENDUM.

APPENDICES ARE TO BE PROVIDED BY THE APPLICANT. T H E REQUIRED APPENDICES ARE USTED ON THE

APPLICATION CHECKUST. APPENDICES MUST BE PRESENTED-IN A TABBED MANNER. EACH TAB MUST INDICATE THE'APPENDIX NUMBER. IMMEDIATELY FOLLOWING THE TAB. APPUCANT MUST INSERT A PAGE WITH THE APPENDIX.NUMBER AND ALL INFORMATION APPLICABLE TO THE APPENDIX. IF AN APPENDIX DOES NOT APPLY TOTHE APPLICANT, WRITE "DOES NOT APPLY" ON THE APPENDIX PAGE.

A L L PAGES OF THE FORM MUST BE INITIAL£D BY THE APPLICANT. OR IF THE APPLICAMT IS NOT A NATURAL PERSON, THE PERSON AUTHORIZED TO COMPLETE THE FORM ON BEHALF OF THE APPLICANT MUST INITIAL EACH PAGE. IF ADDITIONAL PAGES ARE REQUIRED IN ORDER TO ANSWER ANY QUESTION, ADDITIONAL PAGES MAY BE UTILIZED AND MUST BE ATTACHED TO THE FORM. B E SURE TO INDICATE THE NUMBER(S) OF THE QUESTION(S) BEING ANSWERED AND INmAL EACH ADDITIONAL PAGE. SOME SCHEDULES MAY REQUIRE DISCLOSURE OF INFORMATION FOR MORE THAN ONE NATURAL PERSON OR ENTITY OR TYPE OF INFORMATION. IF THERE ARE MULTIPLE DISCLOSURES, MAKE ENOUGH ADOmONAL COPIES OF THE BLANK SCHEDULE AND COMPLETE \T FOR EACH NATURAL PERSON OR ENTITY OR TYPE OF INFORMATION.

A L L REQUIRED DOCUMENTATION, SUCH AS BUSINESS FORMATION PAPERS, TAX RETURNS AND APPENDICES, AS WEa AS THE APPLICATION-FORMS THAT COMPRISE AN APPLICATION PACKAGE FOR A SLOT OPERATOR OR MANAGEMENT COMPANY UCENSE, AS USTED ABOVE, MUST BE SUBMITTED AT THE TIME OF FILING THIS FORM. FURTHER, PURSUANT TO 56 PA. CODE §§421A.1(G) AND 4 2 3 A . 1 ( E ) , THE APPLICANT IS Ut DER A CONTINUING DUTY TO PROMPTLY NOTIFY THE BOARD IF THERE IS A CHANGE IN THE INFORMATION PROVIDED tO THE BOARD.

ADDITIONAL FINANCIAL INFORMATION WILL BE REQUESTED AS NEEDED.

SHOULD YOU BE UNABLE TO UNDERSTAND THIS FORM FULLY IN ENGUSH. IT IS YOUR RESPONSiBiLrrv TO

ACQUIRE ADEQUATE MEANS OF TRANSLATION, IF YOU SUBMIT A DOCUMENT TO THE BOARD THAT IS IN A LANGUAGE OTHER THAN ENGUSH, YOU MUST ALSO SUBMrr AN ENGUSH TRANSLATION COMPLIANT WTTH 58PA.CODE§423A:1(H) ,

A L L NOTICES REGARDING YOUR APPLICATION WILL BE SENT TO THE ADDRESS YOU PROVIDE ON THIS

FORM, YOU MUST IMMEDIATELY NOTIFY THE BOARD IF YOU CHANGE YOUR ADDRESS.

FAILURE TO ANSWER ANY QUESTION COMPLETELY AND TRUTHFULLY WILL RESULT IN DENIAL OF YOUR

APPUCATION AND/OR REVOCATION OF YOUR LICENSE, REGISTRATION, CERTIFICATE OR PERMIT AND MAY

SUBJECT YOU TO CRIMINAL PENALTIES UNDER 18 P A . C . S . A. §4903.

A N Y PERSON WHO APPLIES FOR AND OBTAINS A LICENSE, REGISTRATION, CERTIFICATE OR PERMH" FROM THE BOARD MAY BE REQUIRED TO SUBMIT TO WARRANTLESS SEARCHES WHEN PRESENT IN A UCENSED

GAMING FACIUTY PURSUANT TO THE ACT.

CONFIDENTIAL INFORMATION (AS DEFINED IN 58 PA. CODE §401A.3) SUPPUED TO THE BOARD OR

OTHERWISE OBTAINED SHALL NOT BE REVEALED EXCEPT IN THE COURSE OF THE NECESSARY ADMINISTRATION OF THE ACT, OR UPON THE LAWFUL ORDER OF A COURT OF COMPETENT JURISDICTION OR, WfTH THE APPROVAL,OF THE ATTORNEY GENERAL, TO A DULY AUTHORIZED-LAW ENFORCEMENT AGENCY. A N APPUCANT OR UCENSE. REGISTRATION, CERTIFICATE OR PERMIT HOLDER WAIVES ANY LIABILITY OF THE COMMONWEALTH OF PENNSYLVANIA AND ITS INSTRUMENTAUTIES AND AGENTS FOR ANY DAMAGES RESULTING FROM ANY DISCLOSURE OR PUBLICATION IN ANY MANNER, OTHER THAN A WILLFULLY UNLAWFUL DISCLOSURE OR PUBLICATION.

PURSUANT TO 58 PA. CODE § 4 2 3 A . 5 . ONCE THE APPLICATION HAS BEEN FILED. THE APPLICANT MAY ONLY Wn"HDRAW FTS APPUCATION BY FIUNG A PETITION WITH THE BOARD SEEKING PERMISSION TO WITHDRAW.

PGCB-CA-0gi2 -5 Initials

A LICENSE, PERMIT. CERTIFICATION OR REGISTRATION ISSUANCE, RENEWAL OR OTHER AUTHORIZATION ISSUED BY THE BOARD IS A REVOCABLE PRIVILEGE. NO PERSON HOLDING A UCENSE, PERMIT, CERTIFICATION OR REGISTRATION, RENEWAL, OR OTHER AUTHORIZATION IS DEEMED TO HAVE ANY PROPERTY RIGHTS RELATED TO THE LICENSE, PERMIT, CERTIFICATION OR REGISTRATION.

A N APPUCATION THAT HAS BEEN ACCEPTED FOR FILING AND ALL RELATED MATERIALS SUBMHTED TOTHE BOARD BECOME THE PROPERTY OF THE BOARD AND WILL NOT BE RETURNED TO THE APPLICANT.

THIS IS AN APPUCATION FOR A SLOT MACHINE OR MANAGEMENT COMPANY UCENSE. AN ENTITY INTERESTED IN OFFERING TABLE GAMES MUST FIRST OBTAINA SLOT MACHINE UCENSE IN ORDER TO BE ELIGIBLE TO FILE A PETMON SEEKING AUTHORIZATION TO CONDUCT TABLE GAMES. ANY REFERENCES TO TABLE GAMES IN THIS APPLICATION ARE FOR INFORMATIONAL PURPOSES ONLY.

IF YOU HAVE ANY QUESTIONS REGARDING THE APPUCATION PACKAGE FORMS OR THE INFORMATION REQUIRED TO COMPLETE ANY APPLICATION, PLEASE CONTACT THE PENNSYLVANIA GAMING CONTROL BOARD - BUREAU OF LICENSING AT (717) 346-8300.

18

18

S

SLOT OPERATOR OR MANAGEMENT COMPANY!DISCLOSURE INFORMATION FORM (FOR APPLICANT AND EACH OF APPUCANT'S AFFILIATED ENTITIES).

REQUEST F O R U S E OF ALTERNATIVE CoNDmoNwJCATEOORY 1 LICENSING STANDARDS -ADDENDIJM I (FOR CONDITIONAL/CATEGORYT^APPUCANT REQUESTING THATTHE BOARD UTILIZE THE APPLICATION FILED IN AND LICENSE ISSUED BY ANOTHER JURISDICTION).

MuLTi - JURISDICTIONAL PERSONAL HISTORY DISCLOSURE FORM (MULTI - JURISDICTIONAL PHD)(FOR EACH NATURAL PEFISO'N WHO IS A PRINCIPAL OR KEY EMPLOYEE).

PRINCIPAL/KEY EMPLOYEE FORM - PENNSYLVANIA SUPPLEMENT TO THE MULTI - JURISDICTIONAL PERSONAL HISTORY DISCLOSURE FORM (PA SUPPLEMENT) (FOR EACH NATURAL PERSON WHO IS A PRINCIPAL OR KEY EMPLOYEE).

PRINCIPAL ENTITY FORM (FOR EACH ENTITY THAT IS A PRINCIPAL).

PGCB-CA-0912

APPLICANT INFORMATION

^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ m m » M m i 3 m m H m ^ m ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ BUSINESS NAME AS IT APPEARS ON'APPUCANT'S CERtinCA'TB OF INfiORPOf^^

OTHER OFFICIAL DOCUMEtiTS (SPELL OUT COMPLETE NAME, DO NOT USE AflBREVWTIONS)


TRADE NAW,E(S) AND DOING BUSINESS As ("DBA") NAMES

NONE Is THE APPUCANT A MINORFTY OR WOMEN'S BUSINESS ENTERPRISE THAT IS CERTIFIED BY THE BUREAU OF MINORITY AND

WOMEN'S BUSINESS OppoRTUNfTiEs OF THE DEPARTMENT OF GENERAL SERVICES? r n W ITTI . . LJ YES JKi No

IF YES, PROVIDE ENTERPRISE CERTIFICATION NUMBER.

i^^^^^^^^^mmmmmmmmmm^^^mm^^ ADDRESS LJNE 1

515 South Flower Street ADDRESS UNE 2

Suite 2900 ADDRESS UNE 3

CITY

Los Angeles COUKTRY USA COUNTY ICWNSHIP

STATE/PROVINCE

CA POSTAL CODE

90071-2225 EMAIL ADDRESS

teverett@car1 smith .com

PHONE NUMBER ( J

(213)955-1608

WEB UKL

hAX NUMBER ( )

(213)623-0032 j |$ i l i i<BNMivwBK{^iAlw^^

116 Pine street • ADDRESS LINE 2

c/o CT Corporation ADDRESS LINE 3

ste. 320 T^tTY

Harrisburg "COUNTRY"

USA COUNTY

Dauphin

STATE/PROVINCE

PA EMAIL ADDRESS

POSTAL C O D E

17101

PHONE NUMBER (

rOWNSHIP W E B URL

HAX NUMBER ( J

^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ i m ^ m m m t m m m m m m i x m ^ ^ ^ ^ ^ ^ ^ ^ ^ m ^ F I R S T N A M E

A L A N

TTTLE

ESQUIRE

MIDDLE NAME LAST NAME

KOHLER

PHONE NUMBER [-AX NUMBEF

•INDIVIDUAL EMAIL ADDRESS

SUFFIX (JR.. SR.. ETC.)

^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ M ^ ^ ^ ^ ^ ^ S ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ M CHEckdNE

D S O L E PROPRIETORSHIP

J^LlMITED LlABILFTY COMPANY

a OTHER (DESCRIBE)

D PARTNERSHIP

n S-CORPORATION

Q LIMITED PARTNERSHIP

n TRUST

a C-CORPORATION

PGCB-CA-0912 Initl

S ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ M ^ ^ ^ ^ S ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ H HTATE OF INCORPORATION, REGISTRATION OR OTHER TYPE OF FORMATION

DELAWARE APPLICANTS BUSINESS NAME AS R" APPEARS ONTHE FORMATION DOCUMENTS


DATE OF FORMATION

10/23/2012

U S T ALL STATES IN WHICH THE APPLICANT IS CURRENTLY REGISTERED OR AUTHORIZED TO DO BUSINESS

DELAWARE. PENNSYLVANIA ^ COMPLETE SCHEDULE 1 CONCERNING APPLICANTS INCORPORATORS/FOUNDERS

Is APPUCAWT REGISTERED OR AUTHORIZED TO DO BUSINESS IN THE COMMONWEALTH OF PENNSYLVANIA? ° Y E S '"' NO

PA DEPARTMENT OF REVENUE CORPORATE BOX NUMBER

^RSCOMPENSAl

PA LIQUOR CONTROL BOARD LICENSE NUMBER

DOES NOT APPLY ' PA DEPARTMENT OF STATE - ENTITY, NUMBER

4142720 U O E S T H E APPLICANT HAVE ANY OUTSTANDING TAX LIABILITIES TO EITHER THE tJOMMONWEALTH OF PENNSYLVANIA OR ANY

OTHER STATE, LOCALHY OR THE FEDERAL GOVERNMENT?

IF YOU ANSWER YES. PROVIDE DETAILS CONCERNING ALL OUTSTANDING TAX UABIUTIES.

ADDRESS 213 MARKET STREET, STH FLOOR UITY" HARRISBURG PHONE NUMBER (

(717)237-7172

aTATE/PROVlNCE PENNSYLVANIA

POSTAL C O D E 17101

FAX NUMBER (•• )

(717)237-6019

^^^mmT^smmm^^m D CONDITIONAL CATEGORY 1

D CATEGORY 1

D CATEGORY 2

D CATEGORY 3

• MANAGEMENT COMPANY

D CONDITIONAL CATEGORY 1 AFFILIATE

D CATEGORY 1 AFFILIATE

B CATEGORY 2 AFFILIATE

D CATEGORY 3 AFFILIATE

D MANAGEMENT COMPANY AFFILIATE

T H E N E X T S E C T I O N A S K S A B O U T A N Y O F F E N S E S O R C H A R G E S A P P U C A N T O R A N Y O F (TS PRINCIPALS OR KEY

EMPLOYEES MAY HAVE COMMHTED OR HAD FILED AGAINST THEM. PRIOR TO ANSWERING THIS QUESTION, CAREFULLY REVIEW THE DEFINn"IONS AND INSTRUCTIONS THAT FOLLOW.

DEFINITIONS FOR PURPOSES OF THIS SECTION:

A. " C R I M E OR O F F E N S E " INCLUDES A L L FELONIES AND MISDEMEANORS, AS WELL AS SUMMARY OFFENSES THAT MAY HAVE REQUIRED YOU TO APPEAR BEFORE A LAW ENFORCEMENT AGENCY, STATE OR F^EDERAL GRAND JURY, JUSTICE COURT, MUNICIPAL COURT, CITY COURT, MIUTARY COURT OR ANY OTHER COURT E X C E P T JUVENILE COURT. INCLUDE ALL DUI /DWI OFFENSES.

B. " A R R E S T " I N C L U D E S A N Y TIME THAT YOU WERE STOPPED BY A POLICE OFFICER

OR OTHER_LAW ENFORCEMENT OFFICER AND ADVISED THAT YOU WERE UNDER

^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ m m m m i m m ^ m ( ^ § ^ ^ ^ ^ m ^ ^ m ^ m ^

* S t a d i u m C a s i n o I n v e s t o r s , L L C i s a r e c e n t l y f o r m e d e n t i t y i n p r o c e s s o f s e c u r i n g a l l n e c e s s a r y s t a t e a n d f e d e r a l t a x a n d e m p l o y m e n t i d e n t i f i c a t i o n n u m b e r s a n d w i l l p r o v i d e t h o s e t o the B o a r d a s s o o n a s t h e y a r e a v a i l a b l e .

PGCB-CA-0912 5 Ir^lials

INSTRUCTIONS

ARREST, DETAINED. HELD FOR QUESTIONING. REQUESTED BYA POUCE OFFICER OR LAW ENFORCEMENT OFFICER TO COME TO A POLICE STATION AND ANSWER QUESTIONS, TAKEN INTO CUSTODY BY ANY POLICE OFFICER OR OTHER LAW ENFORCEMENT OFFICER. FINGERPRINTED. HELD IN JAIL, OR INSTRUCTED TO APPEAR IN COURT OR SUBPOENAED TO ANSWER FOR CONDUCT WHICH IS A CRIME AS HAS BEEN DEFINED IN PARAGRAPH "A."

C. "CHARGE" INCLUDES ANY INDICTMENT, COMPLAINT, INFORMATION. SUMMONS, CITATION OR OTHER NOTICE OF THE'ALLEGED COMMISSION OF ANY CRIME OR OFFENSE AS DEFINED IN PARAGRAPH "A."

1. ANSWER "YES" AND PROVIDE ALL INFORMATION TO THE BEST OF YOUR, ABILITY EVEN IF:

A. You DID NOT COMMIT THE OFFENSE CHARGED;

B. THE ARREST .OR CHARGES WERE DISMISSED OR THE CHARGES WERE SUBSEQUENTLY DOWNGRADED TO A LESSER CHARGE;

C. You PLEADED NOT GUILTY OR NOLO CONTENDERE;

D. You COMPLETED AN ACCELERATED REHABILITATIVE DiSPOSmON ("ARD") OR EQUIVALENT DIVERSIONARY PROGRAM;

E. THE CHARGES OR CONVICTION WERE EXPUNGED FROM YOUR RECORD, EVEN IF YOU HAVE EXPUNGEMENT PAPERS;

F. You WERE NOT CONVICTED OR WERE FOUND "NOT GUILTY"

G. You DID NOT SERVE ANY TIME IN PRISON OR JAIL;

H. THE ARRESTS, CHARGES OR OFFENSES HAPPENED A LONG TIME AGO;

I. You WERE ARRESTED O R C H A R G E D IN ANOTHER STATE (A STATE OTHER THAN PENNSYLVANIA);

J . You WERE NEVER PHYSICALLY TAKEN INTO CUSTODY AND/OR TRANSPORTED TO A POLICE STATION OR JAIL.

ANSWER "NO" IF:

A. You HAVE NEVER BEEN ARRESTED OR CHARGED Wrm ANY CRIME OR OFFENSE;

B. YOUR ARREST HAPPENED WHEN YOU WERE UNDER 18 YEARS OF AGE AND YOUR COURT APPEARANCE WAS IN JUVENILE COURT.

FAILURE TO FULLY ANSWER THIS QUESTION MAY RESULT IN THE DENIAL OF YOUR APPLICATION.

2.

1. HAS APPLICANT OR ANY OF ITS PRINCIPALS OR KEY EMPLOYEES EVER BEEN INDICTED, CHARGED WITH OR CONVICTED OF A CRIMINAL OFFENSE OR BEEN A PARTY TO OR NAMED AS AN UNINDICTED CO-CONSPIRATOR IN ANY CRIMINAL PROCEEDING IN THE COMMONWEALTH OR ANY OTHER JURISDICTION?

1. A. HAS APPUCANT OR A N Y OF ITS PRINCIPALS OR KEY EMPLOYEES EVER BEEN CONVICTED OF A FELONY?

1. B. HAS APPLICANT OR ANY OF CTS PRINCIPALS OR KEY EMPLOYEES EVER BEEN CONVICTED OF A MISDEMEANOR OR GAMBLING OFFENSE?

IF YOU ANSWER YES TO ANY OF THESE QUESTIONS, YOU MUST COMPLETE SCHEDULE 23 CONCERNING CRIMINAL HISTORY.

a YES 0 N O

n YES 0 NO

O YES El NO

sa-g.pt;

2. HAS APPUCANT OR ANY OF ITS PRINCIPALS OR KEY EMPLOYEES EVER BEEN CAUED TO

PGCB-CA-0912 Initials

http://sa-g.pt

TESTIFY BEFORE, BEEN THE SUBJECT OF AN INVESTIGATION CONDUCTED BY, OR REQUESTED TO TAKE A POLYGRAPH EXAM BY ANY GOVERNMENTAL AGENCY, COURT, COMMITTEE. GRAND JURY OR INVESTIGATORY BODY (MUNICIPAL, STATE, COUNTY, PROVINCIAL, FEDERAL, NATIONAL. ETC.) OTHER THAN IN RESPONSE TO MINOR TRAFFIC RELATED OFFENSES?

IF YOU' ANSWER YES, YOU MUST COMPLETE SCHEDULE 24 CONCERNING TESTIMONY, INVESTIGATIONS OR POLYGRAPHS.

3. HAS APPUCANT, OR ANY OF ITS /VFFILIATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING

COMPANIES EVER HAD A JUDGMENT, ORDER, CONSENT DECREE OR CONSENT ORDER

PERTAINING TO A VIOLATION OR ALLEGED VIOLATION OF THE FEDERAL ANTITRUST, TRADE REGULATION OR SECURmES LAWS, OR SIMILAR U\WS OF ANY STATE. PROVINCE OR COUNTRY ENTERED AGAINST rr?

4. IN THE PAST TEN (10) YEARS, HAS APPUCANT, OR ANY OF ITS AFFILIATES. INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES HAD A JUDGMENT. ORDER, CONSENT DECREE OR CONSENT ORDER PERTAINING TO ANY STATE OR FEDERAL STATUTE, REGULATION OR CODE THAT RESULTED IN A FINE OR PENALlS- OF $50,000 OR MORE ENTERED AGAINST IT?

IF YOU ANSWER YES TO EITHER QUESTION, YOU MUST COMPLETE SCHEDULE 26 CONCERNING ANTRTRUST, TRADE REGULATION & SECURITY JUDGMENTS; STATUTORY AND

REGULATORY VIOLATIONS.

5. HAS APPLICANT, OR ANY OF n"S AFFILIATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING

COMPANIES HAD ANY PETmON UNDER ANY PROVISION OF THE FEDERAL BANKRUPTCY CODE OR UNDER ANY STATE INSOLVENCY LAW FILED BY OR AGAINST IT IN THE LAST TEN (10) YEAR PERIOD?

D Y E S d N O

D Y E S (3NO

6. HAS APPLICANT. OR ANY OF ITS AFFIUATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES SOUGHT RELIEF UNDER ANY PROVISION OF THE FEDERAL BANKRUPTCY CODE OR UNDER ANY STATE INSOLVENCY LAW IN THE LAST TEN '(10 j YEAR PERIOD?

7. HAS A COURT APPOINTED ANY RECEIVER, FISCAL AGENT, TRUSTEE, REORGANIZATION

.TRUSTEE, OR SIMILAR OFFICER FOR APPLICANT, OR ANY OF ITS AFFILIATES, INTERMEDIARIES,

SUBSIDIARIES OR HOLDING COMPANIES IN THE LAST TEN ( 1 0 ) YEARS?

IF YOU ANSWER YES TO ANY OF THESE QUESTIONS, YOU MUST COMPLETE SCHEDULE 27 CONCERNING BANKRUPTCY OR INSOLVENCY PROCEEDINGS,

8. HAS APPUCAE^, OR ANY OF ITS AFFILIATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING

COMPANIES APPUED FOR ANY UCENSE OR PERMIT BY A GOVERNMENT AGENCY FOR THE COLLECTiON'OF SALES AND USE TAX, SELUNG AND SERVING UQUOR AND MALT BEVERAGES, PROVIDING OVERNIGHT LODGING SERVICES OR ANY OTHER ACTIVITY REQUIRING A LICENSE OR PERMn^ A GOVERNMENT AGENCY AS^ USED HERE INCLUDES ANY SUBORDINATE CREATURE OF FEDERAL. STATE, NATIVE AMERICAN OR LOCAL GOVERNMENT CREATED TO CARRY OUT A GOVERNMENTAL FUNCTION OR TO IMPLEMENT. A STATLTTE OR STATUTES.

IF YOU ANSWER YES. YOU MUST COMPLETE SCHEDULE 28 CONCERNING NON-GAMING

LICENSES AND PERMrrs.

DYES EINO

QYES EINO

DYES E3NO

n YES 0 NO


9. HAS APPUCANT. OR ANY OF ITS AFFILIATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING

C O M P A N I E S APPUED FOR ANY LICENSE OR PERMIT BY A GOVERNMENT AGENCY CHARGED WITH REGULATING GAMES OF CHANCE. INCLUDING BUT NOT LIMITED TO SLOT MACHINES, VIDEO LOTTERY TERMINALS, TABLE GAMES, HORSE RACING, JAIALAI, ETC:? A GOVERNMENT AGENCY AS USED HERE INCLUDES ANY FEDERAL, STATE; NATIVE AMERICAN OR LOCAL GOVERNMENT CREATED TO CARRY OUT A GOVERNMENTAL FUNCTION OR TO IMPLEMENT-A STATUTE OR STATUTES.

I F YOU ANSWER Y E S . YOU MUST COMPLETE SCHEDULE 29 CONCERNING G A M I N G LICENSES

AND PERMrrs.

10. DURING THE LAST TEN (10) YEAR PERIOD, HAS APPLICANT, ITS PARENT COMPANY, OR

ANY OF rrs A F F I L I A T E S , INTERMEDIARIES, SUBSIDIARIES, HOLDING COMPANIES, PRINCIPALS. E M P L O Y E E S O R A N Y THIRD PARTIES ACTING FOR'OR ON BEHALF OF APPUCANT MADEANY BRIBES OR KICKBACKS OR MADE ANY PAYMENTS ALLEGED TO HAVE BEE^i BRIBES OR KICKBACKS TO ANY EMPLOYEE, PERSON, COMPANY OR ORGANIZATION TO OBTAIN FAVORABLE TREATMENT?

DYES (^.NO

11. DURING THE LAST TEN (10) YEAR PERIOD, HAS APPLICANT, n"s PARENT COMPANY, OR ANY OF ITS AFFILIATES. INTERMEDIARIES, SUBSIDIARIES, HOLDING COMPAhJIES, PRINCIPALS, E M P L O Y E E S O R A N Y T H I R D PARTIES ACTING FOR OR ON BEHALF OF THE APPUCANT MADE ANY BRIBES OR KICKBACKS OR tAADE ANY PAYMENTS ALLEGED TO HAVE BEEN BRjBES OR KICKBACKS TO ANY GOVERNMENT OFFICIAL, DOMESTIC OR FOREIGN TO OBTAIN FAVORABLE TREATMENT?

12. DURING THE LAST TEN (10) YEAR PERIOD, HAS APPUCANT, ITS PARENT COMPANY OR ANY OF N"S AFFIUATES, INTERMEDIARIES, SUBSIDIARIES, HOLDING-COMPANIES. PRINCIPALS, EMPLOYEES OR ANY THIRD PARTIES FOR OR ON,BEHALF OF APPLICANT LOANED FUNDS FOR THE PURPOSE OF OPPOSING OR SUPPORTING ANY GOVERNMENT, POUTICAL PARTY, CANDIDATE OR COMMITTEE; EITHER DOMESTIC OR FOREIGN? '

13. D U R I N G T H E L A S T T E N (10) Y E A R P E R I O D , H A S fiPPucAtn, ITS P A R E N T C O M P A N Y , O R

ANY OF rrs.AFFILIATES, INTERMEDIARIES, SUBSIDIARIES. HOLDING COMPANIES, PRINCIPALS, E M P L O Y E E S O R ANY THIRD PARTIES ACTING FOR OR ON BEHALF OF APPLICANT DONATED OR LOANED PROPERTY OR ANY OTHER THING OF VALUE, OR ORGANIZED, SPONSORED OR PARTICIPATED IN FUNDRAISING ACTIVITIES FOR THE PURPOSE OF OPPOSING OR SUPPORTING ANY GOVERNMENT, POLmCAL PARTY, CANDIDATE OR COMMITTEE, EITHER DOMESTIC OR, FOREIGN?

14A. D U R I N G THE LAST TEN (10) YEAR PERIOD, HASAPPLICANT, ITS PARENT COMPANY, OR ANY OF ITS AFFILIATES. INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES MADE ANY LOANS, DONATIONS OR OTHER DISBURSEMENTS TO PRINCIPALS. EMPLOYEES OR ANY THIRD PARTIES FOR THE PURPOSE OF REIMBURSING SUCH INDIVIDUALS FOR POUTICAL CONTRIBUTIONS EITHER FOREIGN OR DOMESTIC?

14B. DURING THE LAST TEN (10) YEAR PERIOD, HAS APPUCANT, ITS PARENT COMPANY;,OR

ANY OF ITS AFFIUATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES,FORMED OR CAUSED TO BE FORMED, A POUTICAL ACTION COMMITTEE EITHER UNDER FEDERAL OR STATE ELECTION LAWS?

14C. A s A RESULT OF THE CmZEN'S UNITED V. FEC DECISION. HAS APPLICANT, CTS PARENT

COMPANY, OR ANY OF ITS AFFIUATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING

COMPANIES MADE "INDEPENDENT EXPENDITURES", AS DEFINED IN S E C . 1 6 2 1 ( E ) OF THE

PENNSYLVANIA ELECTION CODE, FOR THE PURPOSE OF INFLUENCING AN ELECTION

-COVERED BY THE PENNSYLVANIA ELECTION CODE?

v m ll

PGC&-CA-0912

15. DURING THE LAST TEN (10) YEAR PERIOD, HAS APPUCANT. ITS PARENT COMPANY, OR ANY OF ITS AFFILIATES. INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES MAINTAINED ANY BANK ACCOUNT. DOMESTIC OR FOREIGN, NOT REFLECTED ON THE APPUCANTS BOOKS OR RECORDS? SEE SCHEDULE 30

16. DURING THE LAST TEN (10) YEAR PERIOD, HAS.APPLICANT, ITS PARENT COMPANY, OR ANY OF ITS AFFILIATES, INTERMEDIARIES, SUBSIDIARIES OR HOLDING COMPANIES MAINTAINED ANY NUMBERED ACCOUNT OR ANY ACCOUNT IN THE NAME OF A NOMINEE FOR APPUCANT?

IF YOU AUS'NEH YES TO ANY OF THESE QUESTIONS, YOU MUST COMPLETE SCHEDULE 30, CONCERNING CONTRIBUTIONS AND DISBURSEMENTS.

Inli

APPLICATION CHECKLIST

PLACE A CHECKMARK IN THE BOX NEXT TO EACH ITEM APPUCANT HAS ATTACHED TO THIS APPLICATION AND DISCLOSURE INFORMATION FORM.

EACH, ITEM MARKED AS M A N D A T O R Y MUST BE COMPLETED AND SUBMITTED AS PART OF THIS APPLICATION FORM^ IF ANY ITEM IS MISSING, THE APPLICATION wia BE CONSIDERED INCOMPLETE AND WILL N O T BE P R O C E S S E D : IF A QUESTION, SCHEDULE OR ADDENbUM DOESlNOT APPLY TO THE - APPUCANT. YOU MUST WRni "DOES NOT APPLY" IN EACH FIELD OF THE QUESTION, SCHEDULE OR ADDENDUM.

B

B

B

B

sa

Q

B

B

B

B

B

B

B

SCHEDULE 1: INCORPORATORS/FOUNDERS

SCHEDULE 2: OTHER NAMES USED BY APPUCANT

SCHEDULE 3: ADDRESSES CURRENTLY USED BY APPUCANT

SCHEDULE 4: ADDRESSES USED BY APPUCANT

SCHEDULES: CURRENT OFFICERS. DIRECTORS/PARTNERS AND TRUSTEES

SCHEDULE 6: FORMER (NO LONGER ACTIVE) OFFICERS, DIRECTORS/PARTNERS AND TRUSTEES

SCHEDULE 7: EMPLOYEES EARNING OVER $250,000 IN ANNUAL COMPENSATION FROM APPLICANT

SCHEDULE 8: BONUS. PROFIT SHARING. PENSION RETIREMENT, DEFERRED COMPENSATION & SIMILAR PLANS

SCHEDULE 9: STOCK DESCRIPTION (FOR C CORPORATIONS, S-CORPORATIONS, LLCs)

SCHEDULE 10: VOTING SHAREHOLDERS (FOR C CORPORATIONS, S-CORPORATIONS, LLCs)

SCHEDULE IOA: INTEREST OF CURRENT PARTNERS (FOR PARTNERSHIPS, LLPS, LIMITED PARTNERSHIPS, LLCs)

SCHEDULE IOB: INTEREST OF FORMER PARTNERS (FOR PARTNERSHIPS, LLPS. LIMITED PARTNERSHIPS. LLCS)

SCHEDULE 11: NON-VOTING SHAREHOLDERS (FOR C CORPORATIONS. S-CORPORATIONS, LLCS)

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

PGCB-CA-0912 10 Initials

0

gj

El

^

El

^

t i

0

.?1

0

0

ri

p{

0

0

0

g].

ei

e]

ri

0

ri

ri

0

ri

ri.

D

SCHEDULE 12: LONG TERM DEBT

SCHEDULE 13: HOLDERS OF LONG TERM DEBT

SCHEDULE 14: OTHER INDEBTEDNESS AND SECURITY DEVICES

SCHEDULE 15: HOLDER OF OTHER INDEBTEDNESS

SCHEDULE 16: SECURITIES OPTIONS

SCHEDULE 17: BENEFICIAL OWNER OF OPTIONS

SCHEDULE 18: OTHER PRINCIPALS

SCHEDULE 19: FINANCIAL INSTITUTIONS

SCHEDULE 20: CONTRACTS

SCHEDULE 21: STOCK HELD BY APPLICANT

SCHEDULE 22: INSIDER TRANSACTIONS

SCHEDULE 23: CRIMINAL HISTORY

SCHEDULE 24: TESTIMONY, INVESTIGATIONS OR POLYGRAPHS

SCHEDULE 25: EXISTING LITIGATION

SCHEDULE 26: ANTn"RUST. TRADE REGULATION /^ND SECURITY JUDGMENTS;

STATUTORY AND REGULATORY VIOLATIONS

SCHEDULE 27: BANKRUPTCY OR INSOLVENCY PROCEEDINGS

SCHEDULE 28: NON-GAMING LICENSES AND PERMITS

SCHEDULE 29: GAMING LICENSES AND PERMITS

SCHEDULE 30: APPLICANT'S CONTRIBUTIONS AND DISBURSEMENTS

SCHEDULE 31: APPLICANT BACKGROUND PART .1

SCHEDULE 32: APPLICANT BACKGROUND PART 2

APPLICATION FOR PENNSYLVANIA TAX CLEARANCE REVIEW

AFFIDAVIT

RELEASE AUTHORIZATION

WAIVER OF LiASiLmr

DiVERsrrY PLAN STATEMENT

CONDITIONAL/CATEGORY 1 APPLICANT'S AFFIRMATION

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

CATEGORY 1 APPLICANT ONLY


•

a

ri

^

^

e\

^

^

^

ADDENDUM 1 - REQUEST FOR USE OF. ALTERNATIVE CATEGORY 1 SLOT MACHINE

LICENSING STANDARDS FORM

ALTERNATIVE LICENSING AFFIDAVIT

UCENSED ENTHY REPRESENTATIVE REGISTRATION

ANNUAL CERTIFICATION TO PREVENT VIOLATIONS OF SECTION 1513 FORM

PENNSYLVANIA POLITICAL CONTRIBUTIONS FORM

FINANCIAL STATEMENT CERTIFICATION

MULTI-JURISDICTIONAL PERSONAL HISTORY DISCLOSURE FORM (ONE FOR EACH

NATURAL PERSON WHO IS A PRINCIPAL OR KEY EMPLOYEE)

PRINCIPAL/KEY EMPLOYEE FORM - PENNSYLVANIA SUPPLEMENT TO THE MULTI-JURISDICTIONAL PERSONAL HISTORY DISCLOSURE FORM (ONE FOR EACH NATURAL PERSON WHO IS A PRINCIPAL OR KEY EMPLOYEE)

PRINCIPAL ENTITY FORM (ONE FOR EACH ENTITY THAT IS A PRINCIPAL)

CATEGORY 1

APPUCANT ONLY

OPTIONAL CATEGORY 1 APPUCANT ONLY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY


APPENDICES

APPENDICES: THE APPENDICES AF^ DOCUMENTS THE APPLICANT MUST PROVIDE OR CREATE. THE APPENDICES

ARE NOT REPRESENTED IN THE APPUCATION QUESTIONS OR rrs SCHEDULES OR ADDENDA. EACH APPENDIX

SHALL BE PRESENTED IN A TABBED MANNER AND EACH TAB MUSTINDICATE THE APPENDIX NUMBER AS USTED

BELOW. IF AN APPENDIX DOES NOT APPLY TO AN AppucAffr, WRHE "DOES N O T APPLY" ON THE APPENDIX PAGE.

ri

ri

?j

ri

d -

ti

ri'

ri

ri

• r i '

ri

ri

t i

APPENDIX 1: DESCRIPTION OF THE.BUSINESS CURRENTLY PERFORMED AND THE BUSINESS INTENDED TO BE PERFORMED IN THE COMMONWEALTH. THIS INFORMATION MUST BE SPECIFIC AND MUST BE ORGANIZED AROUND THE TOPICS SHOWN IN SCHEDULES 31 AND 32. ADDITIONALLY, APPUCANT MUST INDICATE THE

RELATIONSHIP BETWEEN H" AND rtS AFFILIATED ENTITIES AS IT RELATES TO THE BUSINESS INTENDED TO BE PERFORMED IN THE COMMONWEALTH IN THE FORM OF AN ORGANIZATION CHART WrtH A NARRATIVE DESCRIPTION.

APPENDIX 2: DESCRIPTION OF ANY FORMER BUSINESS ENGAGEDIN DURING THE

LAST TEN (10) YEARS AND THE REASON FOR CESSATION OF THE BUSINESS.

APPENDIX" 3: DESCRIPTION OF ALL BONUS, PROFIT-.SHARING, PENSION,-RETIREMENT. DEFERRED COMPENSATION AND SIMILAR PLANS. THIS INFORMATION

MUST BE PROVIDED IN ADOmON TO THE INFORMATION PROVIDED IN SCHEDIJLE 8.

APPENDIX 4: DESCRIPTION OF LONG TERM DEBT. THIS INFORMATION MUST BE PROVIDED IN ADOMON TO THE INFORIWLATION PROVIDED IN SCHEDULES 1 2 AND 13.

APPENDIX 5: DESCRIPTION OF OTHER INDEBTEDNESS AND SECURITY, DEVICES.

THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED

IN SCHEDULES 14 AND 15.

APPENDIX 6: DESCRIPTION OF SECURITIES OPTIONS. THIS INFORMATION MUST BE PROVIDED IN ADDITION TOTHE INFORMATION PROVIDED IN SCHEDULES 16 AND 17.

APPENDIX?: DESCRIPTION OF.EXISTING LmoATiON. THIS INFORMATION MUST BE PROVIDED IN ADOmON TOTHE INFORMATION PROVIDED IN SCHEDULE 25.

APPENDIX 8: AUDITED FINANCIAL STATEMENT FOR THE LAST FISCAL YEAR. IF THE APPUCANT DOES NOT NORMALLY HAVE ITS FINANCIAL STATEMENTS AUDITED, ATTACH UNAUDITED FINANCIAL STATEMENTS.

APPENDIX 9: AUDITED FINANCIAL STATEMENTS FOR THE LAST FIVE (5) YEARS. IF

THE APPUCANT DOES NOT NORMALLY HAVE ITS FINANCIAL STATEMENTS AUDrrED.

ATTACH UNAUDITED FINANCIAL STATEMENTS.

APPENDIX 10: ANNUAL REPORTS FOR THE LAST FIVE (5) YEARS.

APPENDIX 11A: ANNUAL REPORTS PREPARED ON THE SEC'S IOK FOR THE LAST FIVE (5) YEARS.

APPENDIX 11B: COPIES OF ANNUAL OR QUARTERLY FILINGS FOR THE LAST FIVE (5) YEARS REQUIRED UNDER THE LAWS OF A REGULATORY AGENCY OF ANOTHER COUNTRY.

APPENDIX,12: A COPY OF THE LAST QUARTERLY UNAUDITED FINANCIAL STATEMENT.

APPENDIX 13: A COPY OR COPIES OF ANY INTERIM REPORTS.

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

PGCB-CA-0912 13 tnilia

• rii

t

t

ri

ri

^

f^

ri

rii

ri

ri

^

APPENDIX 14: A COPY OF THE LAST DEFINH IVE PROXY OR INFORMATION STATEMENT (SEC).

APPENDIX 15: A COPY OF ALL REGISTRATION STATEMENTS FOR THE LAST FIVE (5) YEARS FILED IN ACCORDANCE WITH THE SECURITIES ACT OF 1933.

APPENDIX 16: COPIES OF ALL OTHER REPORTS PREPARED IN THE LAST FIVE (5) YEARS BY INDEPENDENT AUDITORS OF THE APPLICANT.

APPENDIX 17: CERTIFIED COPIES OF THE ARTICLES OF INCORPORATION, CHARTER, BYLAWS, PARTNERSHIP AGREEMENT OR OTHER OFFICIAL DOCUMENTS AND ALL AMENDMENTS AND PROPOSED AMENDMENTS.

APPENDIX 18: CURRENT OWNERSHIP TABLE OF ORGANIZATION.

APPENDIX 19: FUNCTIONAL T /^LE OF ORGANIZATION FOR APPLICANT WITH, JOB DESCRIPTIONS, AND NAMES OF EMPLOYEES EARNING IN EXCESS OF $250,000 IN ANNUAL COMPENSATION.

APPENDIX 20: COPIES OF FEDERAL ENTITY TAX FILINGS, INCLUDING FORMS 1120, 1120-S, T120-F. 1065. 941 AND ALL OTHER BUSINESS RELATED TAX FORMS FILED Wn"H THE IRS IN THE LAST FIVE (5) YEARS.

APPENDIX 21 : COPIES OF 5500 FORMS FILED WITH THE IRS IN THE LAST FIVE (5) YEARS.

APPENDIX 22: DESCRIBE CRIMINAL HISTORY OF APPUCANT. THIS INFORMATION MUST BE PROVIDED IN ADOn lON TO THE INFORMATION PROVIDED IN SCHEDULE 23. NARRATIVE INFORMATION ABOUT THE NATURE OF CHARGE OR COMPUINT AND THE DISPOSITION MUST BE PROVIDED.

APPENDIX 23: PURSUANT TO §1312 OF THE GAMING ACT, THE BOARD MAY NOT APPROVE AN APPLICATION FOR LICENSURE IF ANY OF ITS PRINCIPALS DO NOT MEET THE CHARACTER REQUIREMENTS OF §1310, EUGIBIUTY REQUIREMENTS. OR PURCHASES A CONTROLLING INTEREST IN A UCENSED GAMING ENTITY IN VIOLATION OF §1328.

HAS THE APPLICANT DIVESTED ALL INTERESTS THAT WOULD PROHIBn" UCENSURE AND ELIMINATED ANY PRINCIPAL WHO DOES NOT MEET THE CHARACTER OR EUGIBILny REQUIREMENTS? IF NOT, PROVIDE AN EXPLANATION. IF R" DOES NOT APPLY, WRn"E DOES NOT APPLY IN RESPONSE TO THIS APPENDIX.

APPENDIX 24: PURSUANT TO §1330 OF THE GAMING ACT. NO UCENSEE. rrs AFFILIATE, INTERMEDIARY, SUBSIDIARY OR HOLDING COMPANY MAY POSSESS AN OWNERSHIP OR FINANCIAL INTEREST THAT IS GREATER THAN 33 .3% OF ANOTHER SLOT MACHINE LICENSEE OR PERSON EUGIBLE TO APPLY FOR A CATEGORY 1 LICENSE, N S AFFIUATE. INTERMEDIARY, SUBSIDIARY OR HOLDING COMPANY.

DOES THE APPLICANT POSSESS AN OWNERSHIP OR FINANCIAL INTEREST THAT IS GREATER THAN 33 .3% OF ANOTHER SLOT MACHINE LICENSEE OR PERSON EUGIBLE TO APPLY FOR A CATEGORY 1 LICENSE, ITS AFFILIATE, INTERMEDIARY. SUEISIDIARY OR HOLDING COMPANY? PROVIDE AN EXPLANATION OR WRITE "DOES NOT APPLY".

APPENDIX 25: PURSUANT TO §1512 OF THE GAMING ACT, NO EXECUTIVE-LEVEL STATE EMPLOYEE, PUBLIC OFFICIAL, PARTY OFFICER OR IMMEDIATE FAMILY MEMBER THEREOF SHALL HAVE A FINANCIAL INTEREST IN OR BE EMPLOYED. DIRECTLY OR INDIRECTLY, BY ANY LICENSED RACING ENTITY OR LICENSED GAMING ENTITY, OR ANY HOLDING, AFFILLATE, INTERMEDIARY OR SUBSIDIARY COMPANY, THEREOF, OR ANY SUCH APPUCANT.

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY


ri

ri

ri

ri

ri

ri

ri

HAS ANY PUBLIC OFFICIAL OR OTHER PROHIBITED PERSON POSSESSED A FINANCIAL INTEREST IN OR BEEN EMPLOYED DIRECTLY OR INDIRECTLY BY THE APPUCANT OR RELATED ENTITY AT OR FOUOWING THE EFFECTIVE DATE OF THE PA GAMING ACT?

•

APPENDIX 26: PURSUANT TO §1313 OF THE GAMING ACT, PROVIDE INFORMATION, DOCUMENTATION AND' ASSURANCES DEMONSTRATING THAT THE APPLICANT HAS SUFFICIENT BUSINESS ABILITY AND EXPERIENCE TO CREATE AND MAINTAIN A SUCCESSFUL, EFFICIENT OPERATION. ALSO PROVIDE BIOGRAPHIES OF THE KNOWN INDIVIDUALS WHO WILL PERFORM EXECUTIVE MANAGEMENT DUTIES AND PROVIDE NAMES OF ALL PROPOSED KEY EMPLOYEES AND A DESCRIPTIol OF THEIR RESPECTIVE OR PROPOSED RESPONSIBIUTIES AS THEY BECOME KNOWN.

APPENDIX 27: PURSUANT TO §1207(16) OF THE GAMING ACT. THE LICENSEE MUST SELL PENNSYLVANIA STATE L O U E R Y TICKETS AT ITS FACILITY AS NEAR AS PRACTICABLE TO THE PAY WINDOWS. PROVIDE A PROPOSED FLOOR PLAN SPECIFYING THE LOCATIONS WHERE STATE LOTTERY TICKETS WILL BE SOLD AND THE PROXIMITY OF THOSE LOCATIONS TO PAY WINDOWS: (NOTE: THIS SUBMISSION MUST BE RNAUZED AND APPROVED BY THE BOARD PRIOR TO OPERATION).

APPENDIX 28; PROVIDE A UST OF ANY HOSPITAL, PLACE OF WORSHIP, SCHOOL, CHARITABLE INSTITUTION, PARK. ZOO OR ANY SIMILAR PLACE FREQUENTED BY THE PUBLIC WRFHIN 1500 FEET OF THE PROPOSED FACILITY.

APPENDIX 29: SuBMrr AN INITIAL NARRATIVE DESCRIPTION OF PROPOSED ADMINISTRATIVE AND ACCOUNTING PROCEDURES, INCLUDING A WRITTEN SYSTEM OF INTERNAL CONTROL, PURSUANT TO §1322 OF'THE GAMING ACT (NOTE: THIS SUBMISSION MUST BE FINALIZED AND APPROVED BY THE BOARD PRIOR TO OPERATION).

APPENDIX 30: PROVIDE MARI^TING PLANS AND PROPOSALS AND DETAILS OF THE PROXIMITY OF THE FAClLrTY TO ITS MARKETING SERVICE AREA.

APPENDIX 31: PROVIDE COPIES OF LOCAL ZONING AND LAND USE APPROVALS OR A DETAILED EXPUNATION OF THE STATUS OF THE'REQUEST WITH COPIES OF ALL FIUNGS.

APPENDIX 32: PURSUANT TO §1322 OF THE GAMING ACT AND/OR BOARD REGULATIONS, SUBMIT A COMPLETE PROPOSED SITE PLAN OF THE PROPOSED LICENSED FACILITY, INCLUSIVE OF TRAFFIC STUDIES AND THE PARKING PLAN, INCLUDING THE NUMBER OF PARKING SPACES, ACCOMPANIED.BY ARCHITECTURAL DRAWINGS AND A PROPOSED GAMING FLOOR LAYOUT. THE GAMING FLOOR LAYOUT SHOULD CLEARLY DEUNEATE THE SQUARE FOOTAGE OF THE AREA TO BE USED FOR THE PLACEMENT OF SLOT MACHINES AND TABLE GAMES AS WELL AS THE SQUARE FOOTAGE OF THE AREA THAT WILL NOT BE USED FOR THE PLACEMENT OF SLOT MACHINES AND TABLE GAMES. FURTHER, THE GAMING FLOOR LAYOUT SHOULD DELINEATE THE SQUARE FOOTAGE RESERVED FOR ADDITIONAL SLOT MACHINES AND TABLE GAMES PERMITTED PURSUANT TO § 1 2 1 0 AND §13A1 LOF THE GAMING ACT. PURSUANT TO §1210,' PROVIDE-DETAILS OF THE PROPOSED LOCATION OF SLOT MACHINES AND TABLE GAMES AT THE FACILITY AND THE NUMBER OF SLOT MACHINES AND TABLE GAMES REQUESTED. PURSUANT TO §1207 OF THE GAMING ACT. PROPOSED SURVEILLANCE CAMERA LOCATIONS BOTH WITHIN AND OUTSIDE THE PROPOSED UCENSED FACILITY SHOULD ALSO BE CLEARLY DEUNEATED ON THE GAMING FLOOR LAYOUT AS WELL AS PROPOSED SECURFTY ZONES ON THE GAMING FLOOR AND WITHIN AND OUTSIDE THE UCENSED FACIUTY. (NOTE: THE STTE PLAN, GAMING FLOOR LAYOUT AND RELATED SURVEILLANCE AND SECURTTY PROPOSALS MUST BE FINAUZED AND APPROVED BY THE BOARD PRIOR TO OPERATION).

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

PGCB-CA-0912 15 Initi

^

ri

ri

ri

ri

APPENDIX 33: PROVIDE DETAILS OF PLANNED RETAIL AND FOOD VENUES FOR THE

FACILTTY AND THE IDENTIFICATION OF THE OPERATORS OF EACH RETAIL FOOD

VENUE.

APPENDIX 34: PROVIDE A LOCAL IMPACT REPORT, ENGINEERING REPORTS AND TRAFFIC STUDIES, INCLUDING DETAILS OF ANY ADVERSE IMPACT ON TRANSPORTATION, TRANSIT ACCESS,, HOUSING, WATER ANL!) "SEWER SYSTEMS, LOCAL POUCE AND EMERGENCY SERVICE CAPABLLMES. EXISTING TOURISM, INCLUDING HISTORICAL AND CULTURAL RESOURCES OR OTHER MUNICIPAL SERVICE OR RESOURCE. A COPY OF THE LOCAL IMPACT REPORT SHALL BE PROVIDED TO EACH POLITICAL SUBDIVISION IN WHICH THE UCENSED FACILITY WILL BE LOCATED AT LEAST SEVEN (7) DAYS PRIOR TO THE FILING OF THE APPUCATION FOR A SLOT MACHINE LICENSE. THE APPUCANT SHALL FILE A PROOF OF SERVICE WRTH THE BOARD.

APPENDIX 35; PROVIDE DETAILS OF LAND AcouismoN COSTS.

APPENDIX 36: PROVIDE DETAILS OF A COMPULSIVE OR PROBLEM GAMBLING PLAN.

APPENDIX 37: IF A TEMPORARY FACIUTY IS TO BE LICENSED,,PROVIDE DETAILS OF

THE TEMPORARY FACIUTY AS WELL AS A PLAN FOR HOW THE LICENSEE WILL

TRANSITION TO A PERMANENT FACILTTY, INCLUDING A DATE FOR THE COMPLETION

OF THE PERMANENT FACIUTY.

APPENDIX 38; A s REQUIRED BY § 1 3 2 5 OF THE GAMING ACT, APPUCANT MUST ADDRESS EACH n"EM USTED IN THIS SECTION. I F - A N ITEM DOES NOT APPLY, THE APPLICANT MUST STATE THAT IN RESPONSETO EACH ITEM USTED. PROVIDE A PLAN, WTTH DETAILS. FOR THE F0LL0WIN(3:

(1) THE LOCATION AND QUALITY OF THE PROPOSED FACIUTY, INCLUDING, BUT NOT LIMITED TO. ROAD AND TRANSIT ACCESS, PARKING AND CENTRALITY TO MARKET

SERVICE A R E A ;

(2) THEPOTENTIAL FOR NEW JOB CREATION AND ECONOMIC DEVELOPMENT WHICH

WILL RESULT FROM GRANTING A UCENSE TO THE A P P U C A N T ;

(3) THE A P P U C A N T S GOOD FAITH PLAN TO RECRUIT, TRAIN AND UPGRADE

DIVERSITY IN ALL EMPLOYMENT CLASSIFICATIONS IN THE FACILH^;

(4) THE A P P U C A N T S GOOD FAITH PLAN FOR ENHANCING THE REPRESENTATION OF DIVERSE GROUPS IN THE OPERATION OF RRS FACILITY THROUGH THE OWNERSHIP AND OPERATION OF BUSINESS ENTERPRISES ASSOCIATED WITH OR UTILIZED BY ITS FACILITY OR THROUGH THE PROVISION OF GOODS OR SERVICES UTILIZED BY ITS FACIUTY AND THROUGH THE PARTICIPATION IN THE OWNERSHIP OF THE APPUCANT. PROVIDE SPECIFIC INFORMATION REGARDING THE DIVERSFTY IN OWNERSHIP OF THE

APPLICANT, I.E. MlNORrriES. WOMEN;

(5) THE APPLICANTS GOOD FAITH EFFORT TO ASSURE THAT ALL PERSONS ARE ACCORDED EQUALITY OF OPPORTUNITY IN EMPLOYMENT AND CONTRACTING BY FT AND ANY CONTRACTORS, SUBCONTRACTORS, ASSIGNEES, LESSEES, AGENTS, GAMING SERVICE PROVIDERS AND SUPPUERS H" MAY EMPLOY DIRECTLY OR INDIRECTLY;

(6) THE HISTORY AND SUCCESS OF THE APPUCANT IN DEVELOPING TOURISM FACILITIES ANCILLARY TO GAMING DEVELOPMENT, IF APPLICABLE TO THE APPUCANT;

(7) THE DEGREE TO WHICH THE APPLICANT PRESENTS A PLAN FOR THE PROJECT

WHICH WILL UKELY LEAD TO THE CREATION OF QUALITY, UVING-WAGE JOBS AND FULL-TIME PERMANENT JOBS FOR RESIDENTS OF THIS COMMONWEALTH GENERALLY AND FOR RESIDENTS OF THE HOST POLN"LCAL SUBDIVISION IN PARTICULAR;

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY


- r i

(6

'

ri

ri

t '

ri

(3) THE RECORD OF THE APPLICANT AND n"S DEVELOPER IN MEETING COMMrTMENTS TO LOCAL AGENCIES, COMMUNITY-BASED ORGANIZATIONS AND EMPLOYEES IN

• OTHER LOCATIONS;

(9) THE DEGREE TO WHICH POTENTIAL ADVERSE EFFECTS WHICH MIGHT RESULT FROM THE PROJECT, INCLUDING COSTS OF MEETING THE INCREASED DEMAND FOR PUBUC HEALTH CARE, CHILD CARE. PUBLIC TRANSPORTATION, AFFORDABLE HOUSING AND SOCIAL SERVICES, WILL BE MITIGATED;

(10) THE RECORD OF THE APPLICANT AND ITS DEVELOPER REGARDING COMPLIANCE WITH

(I) FEDERAL, STATE AND LOCAL DISCRIMINATION, WAGE AND HOUR, DISABILITY AND OCCUPATIONAL AND ENVIRONMENTAL HEALTH AND SAFETY LAWS AS WELL AS

(II) STATE AND LOCAL LABOR RELATIONS AND EMPLOYMENT LAWS;

(III) THE APPLICANTS RECORD IN DEAUNG WITH ITS EMPLOYEES AND THEIR REPRESENTATIVES AT OTHER LOCATIONS.

APPENDIX 39; PROVIDE INFORMATION DEMONSTRATING ADEQUATE FINA|NCING FOR THE PROPOSED FAClLrTY AND TERMS OF FINANCING INCLUDING PAYBACK PERIOD.

APPENDIX 40: PROVIDE BUSINESS AND ECONOMIC DEVELOPMENT PLANS AND TIMETABLES, PROJECTED DEBT SERVICE EXPENSES, PROJECTED EBITDA AND INTERNAL RATE OF RETURN, PROJECTED ANNUAL GROSS TERMINAL REVENUE, PROJECTED OPERATING AND CAPITAL EXPENSES AND DEFINED GAMING MARKET AND PROJECTED VISITATION.

APPENDIX 41: PROVIDE LEIILRS OF REFERENCE FROM LAW ENFORCEMENT AGENCIES HAVING JURISDICTION IN THE APPLICANT'S AND PRINCIPAL'S MAIN PLACE OF RESIDENCE AND PLACE OF BUSINESS INDICATING THAT THE AGENCY DOES NOT HAVE ANY- PERTINENT INFORMATION RELATING TO THE APPUCANT OR N"S

PRINCIPALS. IF THE LAW ENFORCEMENT AGENCY HAS INFORMATION PERTAINING TO THE APPUCANT OR ITS PRINCIPALS, THE Lh 1 lER SHALL SPECIFY THE DETAILS OF THE INFORMATION.

IF NO LETTERS ARE RECOVED WTTHIN 30 DAYS OF THE REQUEST, THE APPUCANT OR PRINCIPAL MAY SUBMIT A SWORN OR AFFIRMED STATEMENT THAT THE APPUCANT OR PRINCIPAL IS A CITIZEN IN GOOD STANDINGIN HIS JURISDICTION OF RESIDENCE AND PRIMARY PLACE OF BUSINESS.

APPENDIX 42: IF THE APPUCANT HAS HELD A GAMING LICENSE IN ANY JURISDICTION, PROVIDE A LBL ITR OF REFERENCE FROM THE GAIUIING OR CASINO ENFORCEMENT OR REGULATORY AGENCY IN THE OTHER JURISDICTION, SPECIFYING THE EXPERIENCES OF THE AGENCY WITH THE APPUCANT, THE APPLICANT'S ASSOCIATES AND THE APPUCANT'S GAMING OPERATION.

I F NO Lkl IbR IS RECEIVED WrTHIN 30 DAYS OF REQUEST BY THE APPUCANT, THE APPUCANT MAY SUBMrr A SWORN OR AFFIRMED STATEMENT THAT THE APPUCANT'S OPERATION IS IN GOOD STANDING WITH THE REGULATORY AGENCY.

APPENDIX 43: PROVIDE AN ORIGINAL PAYMENT BOND OR AN ORIGINAL IRREVOCABLE LBL LER OF CREDIT THAT INCLUDES A DRAW CERTIFICATE, AT THE APPUCANTS OPTION, GUARANTEEING THE APPUCANT'S PAYMENT OF THE SLOT MACHINE LICENSE FEE REQUIRED BY §1209 (FOR CATEGORY 1 AND 2) AND §1305 (CATEGORY 3) OF THE GAMING ACT.

APPENDIX 44: PROVIDE A CHART OF EXISTING GAMING SERVICE PROVIDERS* INCLUDING THE NAME, ADDRESS, PHONE AND TAX IDENTIFICATION NUMBER OF THE

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY

MANDATORY


ri

GAMING SERVICE PROVIDERS, TYPES OF GOODS AND/OR SERVICES PROVIDED BY THE GAMING SERVICE PROVIDERS, TOTAL DOLLAR AMOUNT OF BUSINESS WTTH GAMING SERVICE PROVIDERS IN THE PAST TWELVE (12) MONTHS AND TOTAL DOLLAR AMOUNT OF BUSINESS EXPECTED TO BE CONDUCTED WN"H GAMING SERVICE PROVIDERS IN THE NEXT TWELVE (12) MONTHS.

' GAMING SERVICE PROVIDERS IS DEFINED IN 58 PA. CODE §401A,3.

APPENDIX 45: PROVIDE A SUMMARY OF ALL PERSONS WHO HOLD AN OWNERSHIP OR OTHER BENEFICIAL INTEREST IN THE APPLICANT AND ANY SUCH INTEREST IN ANY OF RRS PRINCIPAL AFFIUATES OR PRINCIPAL ENTITIES REQUIRED TO BE UCENSED OR PERMITTED IN PENNSYLVANIA; PROVIDED HOWEVER, IF ANY OF THE ENTITIES ARE PUBUCLY TRADED, ONLY INTERESTS EQUAL TO OR EXCEEDING FIVE PERCENT MUST

BE DISCLOSED. OWNERSHIP INTEREST SHOULD BE PROVIDED IN A MANNER CONSISTENT Wn'H THE OWNERSHIP INTEREST REPORT FOUND ON THE BOARD'S WEBSITE UNDER LICENSURE/REPORTS AND GENERAL INFORMATION.

MANDATORY

CATEGORY 1 APPLICANTS ONLY

D

Q

D

P

a

APPENDIX 46: PURSUANT TO §1308(c) OF THE GAMING ACT, THE BOARD ANDTHE COMMISSIONS SHALL NOT CONSIDER ANY APPLICATION FOR A UCENSE IF THE APPLICANT OR ANY PERSON AFFILIATED WITH OR DIRECTLY RELATED TO THE APPUCANT IS A PARTY IN ANY ONGOING CIVIL PROCEEDING IN WHICH THE PARTY IS SEEKING TO OVERTURN OR OTHEFTWISE CHALLENGE A DECISION OR ORDER OF THE BOARD OR COMMISSIONS PERTAINING TO THE APPROVAL, DENIAL OR CONDITIONING OF A LICENSE TO CONDUCT THOROUGHBRED OR HARNESS HORSE RACE MEETINGS RESPECTIVELY WITH PARI-MUTUEL WAGERING OR TO OPERATE SLOT MACHINES.

IS THE APPLICANT OR AFFIUATED PERSON A PARTY TO ANY ONGOING CIVIL PROCEEDINGS SEEKING TO OVERTURN A DECISION OR ORDER OF THE BOARD OR COMMISSIONS? IF YES,.THE BOARD MAY NOT CONSIDER THE APPLICATION. IF NO.

PROVIDE A STATEMENT ASSERTING THAT THE APPLICANT IS NOT CHALLENGING THE BOARD OR COMMISSION'S DECISION OR ORDERS.

APPENDIX 47: PROVIDE A VERIFICATION FROM THE HORSE RACING COMMISSION OR THE HARNESS RACING COMMISSION STATING THAT THE APPLICANT HAS SATISFIED THE UCENSE EUGIBILITY REQUIREMENTS UNDER §1302 OF THE GAMING A C T (RELATING TO CONDITIONAL/CATEGORY 1 SLOT MACHINE LICENSE) AND THAT THE APPUCANT SATISFIES THE LIVE RACING REQUIREMENTS UNDER §1303 OF THE GAMING ACT.

APPENDIX 48: PROVIDE A STATEMENT DETAIUNG THE APPLICANT'S REGULATORY HISTORY AS A UCENSED RACING ENTITY UNDER THE JURISDICTION OF THE .PENNSYLVANIA HORSE RACING COMMISSION OR STATE HARNESS RACING COMMISSION, INCLUDING THE APPUCANT'S HISTORY OF SUITA'BIUTY AND COMPLIANCE WITH THE RACE HORSE INDUSTRY REFORM ACT IN .THE OPERATION OF THE RACE TRACK AND NONPRIMARY LOCATIONS AND THE CONDUCT OF PARI-MUTUEL WAGERING.

APPENDIX 49: PROVIDE A DETAILED PLAN FOR THE MANAGEMENT OF ACCOUNTS CREATED FROM FUNDS ALLOCATED UNDER §1406 OF THE GAMING ACT (RELATING TO DISTRIBUTIONS FROM PENNSYLVANIA RACE HORSE DEVELOPMENT FUND).

APPENDIX 50; PROVIDE A DETWLED PLAN FOR THE MANAGEMENT AND USE OF BACKSIDE AREA IMPROVEMENT AND MAINTENANCE ACCOUNTS UNDER §1404 OF THE GAMING ACT (RELATING TO DISTRIBUTION FROM LICENSEE'S REVENUE RECEIPTS).





CATEGORY 1 APPUCANT ONLY


CATEGORY 3 APPLICANTS ONLY

D

a

a

D

D

APPENDIX 51: PROVIDE .A STATEMENT DETAILING .THE PROPOSED PLANS AND LOCATION OF THE UCENSED FACIUTY AND EXPLAIN HOW THE FACIUTY W I U BE LOCATED AT A WELL-ESTABLISHED RESORT HOTEL (AS DEFINED IN BOARD REGULATIONS). INCLUDE- A STATEMENT OF THE NUMBER OF ROOMS UNDER COMMON OWNERSHIP. AND HOW EACH ROOM IS HELD, I.E. NON-DEEDED TIME SHARE, DEEDED TIME SHARE AND STANDARD HOTEL ROOM. ALSO INCLUDE IN THE STATEMENT A UST OF THE SUBSTANTIAL YEAR-ROUND RECREATIONAL GUEST AMENITIES OFFERED. THE STATEMENT MUST ALSO'DEMONSTRATE COMPLIANCE wrTH THE GEOGRAPHICAL REQUIREMENTS OF §1305(B) OF THE GAMING ACT (RELATING TO CATEGORY 3 SLOT MACHINE UCENSE), WHICH PROVIDES THAT NO

CATEGORY. 3 UCENSEE SHALL BE LOCATED WITHIN 15 UNEAR MILES OF ANOTHER

UCENSED FACIUTY.

APPENDIX 52; • PROVIDE DOCUMENTATION TO THE BOARD PROVING THAT THE APPLICANT IS THE OWNER OF THE WELL-ESTABLISHED RESORT HOTEL OR IS A WHOLLY OWNED SUBSIDIARY OF THE OWNER OF THE WELL-ESTABLISHED RESORT HOTEL.

APPENDIX 53: PROVIDE A STATEMENT DETAIUNG THE APPUCANT'S PROPOSED AMENITIES PLAN. EXPUIN THE AMENITIES THAT THE APPLICANT INTENDS TO MAKE AVAILABLE AT THE RESORT HOTEL AND THE COSTS OF THE AMENITIES TO PATRONS

OF THE RESORT HOTEL.

APPENDIX 54; PROVIDE A PROPOSED FEE SCHEDULE FOR EACH AMENrrr OFFERED - AT THE WELL-ESTABUSHED RESORT AND A JUSTIFICATION FOR HOW THE FEES MEET

THE DEFINITION OF NON-DE MINIMIS CONSIDERATION (AS DEFINED IN BOARD REGULATIONS): THE FEE SCHEDULE SHOULD INCLUDE PROPOSED FEES FOR^ SEASORJAL OR YEAR-ROUND MEMBERSHIPS.

APPENDIX 55; PROVIDE A PLAN DETAILING HOW THE APPLICANT, AS PART OF ITS OPERATIONAL PLAN, WILL MONITOR .THE GAMING AREA TO.ENSURE COMPLIANCE WITH REGULATIONS RELATING TO SELF-EXCLUSION; PERSONS REQUIRED TO BE EXCLUDED AND UNDERAGE GAMING AND THAT ONLY THE FOLLOWING PERSONS ARE PERMITTED TO ENTER THE GAMING AREA: ( 1 ) REGISTERED OVERNIGHT GUESTS; (2) PATRONS OF ONE OR MORE AMENITIES (AS PATRONOF THE AMENITIES IS DEFINED IN BOARD REGULATIONS); (3) AUTHORIZED EMPLOYEES; (4) ANY^OTIHER PERSONS

AUTHORIZED BY THE BOARD. T H E ' PLAN SHOULD INCLUDE METHODS FOR CX)NTR0LUNG ACCESS TO THE GAMING FLOOR BY THOSE INDIVIDUALS ,HOLDING VALID SEASONAL OR YEAR-ROUND MEMBERSHIPS AND PATRONS OF THE AMENITIES SEEKING TO ACCESS THE GAMING FLOOR WR^HlN 72 HOURS OF THE USE OF THE AiyiENITY.







1-

z < o -J

k > CQ Q UJ V} 3 CO

Z oc UJ X 1-

() CM

• D

a lU X

o (/)

a Ul

m u < 5 UJ

> § X (J X

5 o z a: 13 Q

« a o Q: Ul Q. UJ

s 1-

< 2: X O Q: 0. Q. < UJ > o Q

< « w z 3

m z o CO

< X

^ < o

LU

<

UJ X H

o

< UJ Q

to CO LU

U)

CO

Q LU I -

o ID Q Z O

o I -o CO

< X < g _ i Q_ Q_ <

> •

to a UJ (0 u >-UJ CC CC

o </i UJ tn tn UJ oc a Q

< UJ

_ i

a UJ X o

CN

1 ^

k > ta Q Ul 0)

,n Ul CO (0 UJ DC Q

i 3 • UJ X

u

CN

m «

oc m

tn

O a. Q: o u « to z o F o a. CC o u u oc o

0.

s o CO UJ

a u o I -u> at a Ul X u

oo (N

tn O

o a. a o a to tn z o

o Q. CC o o o CC

o tn CC UJ CO

E UJ

oc O tn CC U l Q _J O X UJ CC

< X CO o z F o > o z UJ - J

o u X u to

c^

m UJ

a UJ H 19 Z o

a UJ X

u

,-•3 ' 2 - UJ

UJ <

O CO _ tn

_- <

^

UJ

Q ^ UJ

O z o

UL o t/i CC UJ a -1

o z • • eo ^ UJ - 1 3 a UJ z o to

ND

INC

C

H

MJ

EA

RF

I

^ii « 5 p 3|i i 3 o ^ Q. < ^ S= H Z <

5 > ^

° fi 2 ^ ^ i ^

t 5 o i= CO Q Z ~ o UJ CC £ a: 0,S o o °-_ UJ < Z H- (V-o =) £ w o 2 UJ >J tiJ Q. UJ ^ I to <

^Sg ^ § i § l i i ^ u, m UJ _ UJ Q: ^ Q < O z -p — to S u. S s o n ; ? UJ

2 O tiJ

o "- f z D; >.

O K i f d O o

i ^

CC X o 5 to tE

mo

LU <

Q 52

r Ul

UJ CO

a Ul

ii .± UJ

o CO

< Q

^ S z

^ of UJ

< s iu" 2 U J 9

U l '

-'^ to UJ . J

a UJ X u (0

z o o m « o o t n

a UJ CO

UJ x^ t -O

O z CO _J < a .

o z CC CL

_1 _ I

< CC o u. z o

O

UJ

to z UJ o _ l

a; o h-Z

< CJ

CL

< 2

£5 UJ CC UJ

X to oc UJ z

1 u UJ Q: o z Q: Ul

5 CC

Q: o ^ < UJ

> 1 -

o X CC o >-Q:

• < .

a UJ 2 CC m z

•

z < a: o

-UJ UJ t o z UJ

o

o: O

(-z < u •. CL < z < LL o CO UJ 1 -

O UJ CO

o z 1 -o > UJ X 1 -

_ j

< S: u z

• Q :

- t l .

< to < Q UI CO

z UJ

o _ 1 UJ CD

o 1 -c UJ

ir

o UJ

cr UJ CD

h-o z _ 1

< X CO

> z < CL

5 o o a UJ o

^ UJ

SI -i z UJ

o

z 1 -

to to UJ _ l

Q _ i

o X

b X

<:

CQ 3 CL

< CO

[ -

< X 1 -UJ UJ CO

z UJ o _J

^

•

19

»

•

CO z o

t * - •

CA z - J

<

1 z IZ

CT) T -Ul -J 3 a Ul z (0

CC o z o u o CO CO

< z - J

Q z < CO o z > < CO

-^ z < cn X

^

2 1 -o U) CL CO UJ cr

CC

5 >• o"

z UJ

1 -«

UJ X l -cc UJ

> o z o tJ o <

ci]

(0

5 CC

o in

u UJ oc a UJ X

•H cc UJ a z

UJ tn

CC UJ X 1 -o CO

1 CC

o t -z

5 CL CL < u. 0 UJ UJ

z o z <

o

>

»

20

I

z o o o CM UJ

_ l

a Ul X u CO

>

>

21

) i

o 3 CL

k ca 3 UJ

X o o

UJ

Uf

X u to

i

(N

V

I

22

. 1

£ ? "

" l i s

X I -

u. O CC m z S o u-UJ

o CC m o u. u. O cr o CC

o

, . CJ

Uj' CO

CJ

cr 0. 'S'

- j .A

3 < u. O 1 -CL UI

o UJ

y

V CC

o to X

•J ^ z, y CC

o

"I n UJ X o (0

^ o

n' C) U. z o z < <) n 11. UJ X

UJ Q

> O CC CL r-' III o 2 z o < cr o tn

z g tn UJ u o o (0 m >-UJ cr UJ

> o

^ M l EC UJ

I i P

O OJ

i -* ^

CL CL < I -

o z CO LU

o a

»

i

24

UJ T ;i-ut Q CC CL

aS a

co UI

o z o z g CO UJ

O

o t -

to LU Q UJ cr UJ

CL

<

CD Z P to

UJ - I Z3 a UJ X u (O

^ g

~ Z S "^

2 < S ti

Z 5; H ul '

1 5

\o

Bi

>-

I

s

o

>

o

m<

I '••'t'

'm

I oo

fli

.5

>-

Mo

o 9 a

UJ I O z

• m

l l

F UJ

a CO

o IU ct:

n. UJ

I I I u z IU a.

CO

Lit j '

o V-D

o

< 5 a

UJ

n > I£ (5 • Q.

dDDDDDDD

Q. Q. < H O z CO UJ

o o

^ a ^ z a • £ u m O Q Q-

- , Q O -r Q

Q. to z F •> X Z> O 5 LU

m CO o s a

DDannnnn

O LU UJ

i y 5 o a O 5- q

E 1 : ^ g X ?

o Q 0. m CO 0,5:^0:

dnnDDDaa

y o • K O Z UJ E_ I I I —- f ^

O Q Q- UJCO O 5 CE

nanDDnan

Q ut 2 UJ z g Q O < O z p 5 UJ •" S ° 5S

29

•

OT t s cr Ul Q.

oi

3 a UJ X t j to

]^

Q UJ Z

o UJ

UJ

t3 z IU

o IU

X

z LU to 3

7-O

C D O D - U J C O O ^ Q :

D D a a n a D D

Q.

< o CO UJ o o

O Q

fe ^- i . ^ S § g g 5 S S 5 § § ^ S CD Q CL LU CO o 5 , c r ,

DDDDDDDn

o UJ

o Q i Q z UJ ni i 5 « S z _ UJ UJ

O Q a.

D _ UJ ^

ii UJ to o 5 a:

D a n D D D D a

O Q " O Z UJ .il

y o e a!

B I i l X o

g I £ z z a,

- U J U J S - . ^ ^ -O Q Q - U J O O O 5 K

d D D a a n a a

o

.CO z o

m CC I -z o o (0

k M i:^

3 Q UJ X

u (O

cr < a. • z.

s CQ CO to UJ z CO

CQ

Ul 13' Q UJ X

(0

C < co

C > z < a C (J

c > < c

CK LL t ^ Z

Z <

< c u.

c/: <

c

oc c h -(T. IL > z G

c/: < c

CO Ql

o L l . Q:

99 .o Q . Q . £0

< o z <

= o

c/:io

73

<

o

_ i Q_

CO LU O o

a. <

o z CO

- ^ LU

io

(N W-1

Q_ CL <

z CO LU s

t -

.0. Q Z O cr o LJ < CD CO to UJ ' Z to =1

CQ

ri n UJ

_ j

O UJ X o

CO

w

> _ l Q_ Q_ < o z CO LU O Q

Pennsylvania Ganiing Control Board

Licensed Entity Representation Registration

A Licensed Entity Representative includes any person acting on'behalf of or representing the interest of any applicant, licensee, permittee or registrant, including but not limitedto an attomey (outside counsel representing, the applicant/licensee), agent or lobbyist regarding any matter which may reasonably be expected to come before the Pennsylvania Gaming Gontrol Board ("PGCB"). Please include representatives from law-firms, pyblicTelations firms, representatives from goveniment relations firms and traffic experts.; If any laWfirms were sub-contracted, individuals from these firms who directlyrepresentedithe applicant/licensee.musfalso complete this form.

NAME:

FIRM:

ADDRESS:

CITY:

STATE AND ZIP CODE:

TELEPHONE:

ENTITY REPRESENTED:

SEE REGISTERED REPRESENTATIVES LISTED IN STADIUM CASINO, LLC'S APPLICATION AND DISCLOSURE INFORMATtONFORM.

Pursuant to 4 Pa.C.S., §1202.1(b), 1 am required to register as a licensed entity representative with the PGCB. I have an ongoing duty to regularly update this information and failure to do so could subject my firm and me to a penalty. 1 also.acknowledge that by signing this documentrali information contained herein will be-made available for review by the public and that such information will be posted on the PGCB website pursuant to 4 Pa.C.S., §12()2.1(3).

SIGNATURE: DATE:


» PENNSYLVANIA POLITICAL CONTRIBUTIONS FORM

I N THE CHART BELOW, PROVIDE THE REQUIRED INFORMATION FOR ALL POLITICAL CONTRIBUTIONS. MONETARY OR IN-KIND. TO A CANDIDATE FOR NOMINATION OR ELECTION TO ANY PUBUC OFFICE IN THIS COMMONWEALTH, OR TO ANY POUTICAL COMMrTTEE OR STATE PARTY IN THIS COMMONWEALTH OR TO ANY GROUP, COMMITTEE OR ASSCrciATION ORGANIZED IN SLIPPORT OF ANY SUCH CANDIDATE. POLmCAL COMMITTEE OR STATE PARTY ON OR AFTER THE DATE YOUR ENTFTr'S APPUCATION WAS SUBMITTED TO THE PENNSYLVANIA GAMING CONTROL BOARD (BOARD). T H E A P P U C A N T O R L I C E N S E E M U S T U S T POLFTICAL CONTRIBUTIONS BY n"S AFFILIATES,

INTERMEDIARIES. SUBSIDIARIES. HOLDING COMPANIES, PRINCIPALS AND KEY EMPLOYEES WHO HOLD' SIMILAR GAMING LICENSES IN OTHER JURISDICTIONS. DO NOT INCLUDE CONTRIBUTIONS TO CANDIDATES FOR FEDERAL OFFICES OR TO COMMlTreES OR GROUPS ORGANIZED SOLELY IN SUPPORT OF FEDERAL CANDIDATES.

I F T H E R E IS MORE THAN ONE CONTRIBUTION TO THE SAME CANDIDATE, POLn"lCAL COMMITTEE, STATE PARTY, ETC.,

SEPARATE ENTRIES MUST BE LISTED FOR EACH CONTRIBUTION.

N O T E : I F Y O U N E E D S P A C E F O R ADOmONAL ENTRIES, PLEASE MAKE ADDITIONAL COPIES OF THIS FORM.

DATE OF

CONTRIBUTION

NAME AND ADDRESS OF THE CANDIDATE, POUTICAL COMMITTEE

OR STATE PARTY, OR GROUP, COMMHTEE OR ASSOCIATION

ORGANIZED IN SUPPORT OF SUCH CANDIDATE. PoLmcAL

COMMI1 TEE OR STATE PARTY

DOES NOT APPLY

•

AMOUNT OR VALUE OF

CONTRIBUTION

SIGNATURE OF CEO/AUTHORIZED SIGNATORY DATE SIGNED

PRINTED NAME OF CEO/AUTHORIZED SIGNATORY - TITLE

• I F A P E R S O N OTHER THAN THE C E O OF THIS ENTTTY IS DESIGNATED TO EXECUIB THIS DCKUMENT. THE BOARD MUST BE PROVIDED WfTH A RESOLUTION OR AN AFFIDAVfT. CERTIFIED AS TTIUE AND CORRECT, IDENTIFYING THE INDIVIDUAL SO DESIGNATED, AUTHORIZING THAT INDIVIDUAL TO EXECUTE THE DOCUMENT ON BEHALF OF BOTH THE ENTITY AND THE CEO,

PGCB-CA-0912 67 Initia:

APPENDIX 1

DESCRIPTION.OF THE BUSINESS CURRENTLY PERFORMED AND THE BUSINESS INTENDED TO BE PERFORMED IN THE COMMONWEALTH.'THIS-INFORMATION MUST BE SPECIFIC AND MUST BE ORGANIZED AROUND THE" TOPICS'SHOWN IN S(iHEDULES 31 AND 32. ADDITIONALLY, APPLICANT MUST INDICATE THE RELATIONSHIP BETWEEN IT AND ITS AFFILIATED ENTITIES AS IT RELATES TO THE BUSINESS INTENDED TO BE PERFORMED IN THE COMMONWEALTH IN THE FORM OF AN ORGANIZATION CHART WITH A NARRATIVE DESCRIPTION.

STADIUM CASINO INVESTORS, LLC WAS FORMED AS AN INTERMEDIARY/HOLDING COMPANY OF STADIUM CASINO, LLC TO PROVIDE FINANCIAL SUPPORT FOR STADIUM CASINO, LLC TO MEET ITS FINANCIAL OBLIGATIONS.

(L0497521.1}

APPENDIX 2

DESCRIPTION OF ANY FORMER BUSINESS ENGAGED IN DURING THE LAST TEN (10) YEARS AND THE REASON FOR CESSATION OF THE BUSINESS.

-{L049752I.1}

APPENDIX 3

DESCRIPTION OF ALL BONUS, PROFIT SHARING, PENSION, RETIREMENT,. DEFERRED COMPENSATION AND SIMILAR PLANS. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED IN SCHEDULE 8.

•

• CONFIDENTIAL

{L049752I.!}

APPENDIX 4

DESCRIPTION OF LONG TERM DEBT. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED IN SCHEDULES 12 AND 13.

{L0497S21.1}

APPENDIX 5

DESCRIPTION OF OTHER INDEBTEDNESS AND SECURITY DEVICES. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED IN SCHEDULES 14 AND 15.

:'7:^^. -: , i t -

• • • i f i ; • • •

.''r\HT^^: V_^':a ^

• . ; ' - ' - i V •"

..-•'^ - • * . ' - ' < • ' " ' • - • ' - , T - . ; . - • ' • • - ^ — r . -r"M

• - ' '^^Z('- •* •

•• • J - . - - , . . •

{L049752I.1}

APPENDIX 6

DESCRIPTION OF SECURITIES OPTIONS. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED IN SCHEDULES 16 AND 17.

•

APPENDIX 7

DESCRIPTION OF EXISTING LITIGATION. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE INFORMATION PROVIDED IN SCHEDULE 25.

• • ' ' ' " • • " . . ^ ^ - ^ • ' •

•-,-• '51: J ;f

•v-- ^''';

- . p f 7-7^ • / : " ^ L . ; i > ; - . v , ' ' " . ' -

{L049752L1)

APPENDIX 8

AUDITED FINANCIAL STATEMENT FOR THE LAST FISCAL YEAR. IF THE APPLICANT DOES NOT NORMALLY HAVE ITS FINANCIAL STATEMENTS AUDITED, ATTACH UNAUDITED FINANCIAL STATEMENTS.

APPENDIX 9

AUDITED FINANCIAL STATEMENTS FOR THE LAST FIVE (5) YEARS. IF THE APPLICANT DOES NOTNORMALLY HAVE ITS FINANCIAL STATEMENTS AUDITED, ATTACH UNAUDITED FINANCIAL STATEMENTS.

I

{L0497S21.I)

1,0

I

APPENDIX 10

ANNUAL REPORTS FOR THE LAST FIVE (5) YEARS.

I

{L049752I.I}

APPENDIX 11

APPENDK I IA: ANNUAL REPORTS PREPARED ON THE SEC'S IOK FOR THE LAST FIVE (5) YEARS.

APPENDIX 11B: COPIES OF ANNUAL OR QUARTERLY FILINGS FOR THE LAST FIVE (5) YEARS REQUIRED UNDER THE LAWS OF A -REGULATORY AGENCY OF ANOTHER COUNTRY.

Does Not Apply

'{L0497521,I}

APPENDIX 12

A COPY OF THE LAST QUARTERLY UNAUDITED FINANCIAL STATEMENT

{L0497521.I1

http://%7bL0497521.i1

APPENDIX 13

A COPY OR COPIES OF ANY INTERIM REPORTS.

.{L049752I.1}

APPENDIX 14

A COPY OF THE LAST DEFINITFVE PROXY OR INFORMATION STATEMENT (SEC).

Does Not Apply

.{L049752I.1)

»

•

15

• APPENDIX 15

A COPY OF ALL REGISTRATION STATEMENTS FOR THE LAST FIVE (5) YEARS FILED IN ACCORDANCE WITH THE SECURITIES ACT OF 1933.

Does Not Apply

•

(L0497521.1}

APPENDIX 16

COPIES OF ALL OTHER REPORTS PREPARED IN THE LAST FIVE (5) YEARS'BY INDEPENDENT AUDITORS OF THE APPLICANT.

{U)49752].I1

»

17

» APPENDIX 17

CERTIFIED COPIES OF THE ARTICLES OF INCORPORATION, CHARTER, BYLAWS, PARTNERSHIP AGREEMENT OR OTHER OFFICIAL DOCUMENTS AND ALL AMENDMENTS AND PROPOSED AMENDMENTS:

See Attached

{L049752I.I

» COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS

401 NORTH STREET, ROOM 206 P'O. BOX 8722

HARRISBURG, PA 17105-8722 WWV/.CORPORATIONS.STATE.FA.US/CORP

Stadium Casino Investors, LLC

THE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS IS HAPPY TO SEND YOU YOUR PILED DOCUMENT. THE BUREAU IS HERE TO SERVE YOU AND WANTS TO THANK YOU FOR DOING BUSINESS IN PENNSYLVANIA.

IF YOU HAVE ANY QUESTIONS PERTAINING T'O THE BUREAU, PLEASE VISTF OUR WEB SHE LOCATED AT WV/W.CO R P 0 R A T 7 0 N S . S T A T E P A . U S / C 0 R P OR PLEASE CALL OUR MAIN INFORMATION TELEPHONE NUMBER (717)787-1057. FOR ADDmONAL INFORMATION REGARDING BUSINESS AND / OR UCC FILINGS. PLEASE VISIT OUR ONLINE "SEARCHABLE DATABASE" LOCATED ON OUR WEB SFIE.

• ENTITY NUMBER: 4142720

Eckert Seamans Cherin & Mellott LLC COUNTER, PA

i

http://RP0RAT70NS.STATEPA.US/C0RP

•

Entity il*:-«14Z720 Dale Filed: 10/25)21112

Carol AlcltelB Socretary of Uia Commonweallh

PENNSYLVANIA BEPA3iTMENT OF STATE CORPORATION BOBEAU

Application for Registration - Foreign (l5PB.as.)

^ Rcgi3iardIimitedLJaliilityGeiisxalPBrtneisliip.(§82!l) . • RcgjitcrodUmiiedljabiU^Liimtsd Partnership C§ 8211)

, LimhedPartnerahq) (5 8582) X Ijmitod Liabilitj' Company (§ B9B1)

Kamc Eckert Seamans Chtria & Mellott, LLC

COUNTER/DO NOT MAIL Cily Stale Zip Code

Docunvent wOl be rctnrned to tbo namaanil iddrci lTDil enter la the left.

Commonwealth of Pennsylvania APPLICATION FOR REGISTRATION 3 Poge(5)

Fee: S250 T123(R47CB2

la compliance with ths reqiiirancnts ofthe t^jplicablo provisions (relatiag to rcgistratioii), tht •nadcrsigaed, dcsinng to rcgista- to do basii;eS3 in Ihb Commonwealth, hereby states thai;

1. Tbo name to be regjstciBd JK. Stadium Cwiao Investors, LLC

2, (I/tfie mime setJcrUi mparagraph 1 Is no: cmiilahlefor use In this Commohw'eahli, complete ihe/oUirAnng):

The name midcr which the liinited liability company/limited liability partnerahifVliinited paitntrship ja-oposea to register and do biiainaM ia this Commoawcaldi is:

3. ThenameofdicjtirisdirtioamMleriielawsof^^cbitwasoigauizedmKlihedatcoritsfbimallon:

JuTisdiction; Delgwarc Date of POTmarion: 10/23/2012 .

4. Tbc (a) address ofits initial regjstcrEdofScD in this Commonwealth or (b) name yf its commtrcial registcrBd office provider and the county ofyenno is:

(a) Number and street City Stale Zip Conng'

(b) Nome of Commercial Regjstered Office Provider CT Corporatioa System •

County Dauphin

2012 OCT 25 AN 10: 51

PA DEPT OF STATE

DSCB:15-8981/«2iyS5a2-2

5. Check and bojT tete one tjfthe/oUmv^

. yj _ The .address of Ao office required lo be maiEraiiied by it in flis jnrisdictioa of Its orgonizadon by the laws of that jurisdiction is:

1209 Ormg; Street Wihnfngtnn DE 19S01 Number sxd street City State Z^

It is not required by the laws of its jurisdiction cf otganization to H"*i"fj''' an office therein and the address ofits princ^al offica is:

Number and street City State Zip

6. f tv RutricSed Professional LiTTiitedLtabiliiy Company Only. Strike otii if mapplicable: The-wmpany ti a festaakMl-tJiufLjAlmul Comptoy orgflniBed-to-tgnd -lhg-fe

Limited LiabllitYrartnership and Liniiteil Partocrship: Complete paraKrapbi 7 and 8

TT^^l^namc aiwl business address of each general pjntncr, Kame"-*^ Business Address

The address of the oSicc al which is kept a. list of the n^ts^gd addresses of the limited paitaen aad'lheir capital contribution is:

Kombcr and street City State CoUDfy

The registered partnership hereby nndertaJccs to keep those.records nntil its regjitiatloa to do busln&wujha Commonwealth is cancclod or withdrawn. •,

IN TESTIMONY WITEREOF, the tmdcraigned has caused ihis Application fer Registnitioa to be signed by duly authoiizcd oiScer/membci or manager thcieaf this

.24* day of October 2012_

STADIUM CASINO INVESlEpRS, LLC Name .of Partnaihip/Compsny

(j^ynthiat:! WooIheateT

Title

Sigaature

(De[a'Ware Uie Jirst State

PAGE 1

J , JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF

DELAWARE, DO HEREBY CERTIFY TEE ATTACHED ARE TRUE AND CORRECT

COPIES OF ALL DOCUMENTS ON F I L E OF ."STADIUM CASINO INVESTORS,

LLC" AS RECEIVED AND FILED I N THIS O F F I C E .

THE FOLLOWING DOCUMENTS HAVE BEEN C E R T I F I E D :

CERTIFICATE OF FORMATION, F I L E D THE TWENTY-THIRD DAY OF

OCTOBER, A . D . 2 0 1 2 , AT 1 1 : 1 3 O'CLOCK A . M .

CERTIFICATE OF AtiENDMENT, CHANGING' I T S NAME FROM "WHIPCORD

INVESTORS, LLC" TO "STADIUM CASINO INVESTORS, L L C " , F ILED THE

TWENTY-FOURTH DAY OF OCTOBER, A . D . 2 0 1 2 , AT 9 : 2 0 O'CLOCK A.M.

AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID

CERTIFICATES ARE THE ONLY CERTIFICATES ON RECORD OF THE.

AFORESAID LIMITED L I A B I L I T Y COMPANY, "STADIUM CASINO INVESTORS,

L L C " .

5 2 3 1 5 0 1 8 1 0 0 H

1 2 1 1 7 8 0 6 2 You may verify th ia ce r t i f i c a t e onlina a t coup.dalaifars:gov/authvar. ahtial

AUTHE. jeffiBy W. BuHocW, Secretary of State

|TION: 9950880

DATE: 1 0 - 3 1 - 1 2

<r

»

s t a t e of Delaware Secretary of S t a t e

\ Divisica o£ Cai:po'r&tioBS ) e l±v^ e d 11:32 JOd 10/23/2012

FILED. 11:13 JiM 10/23/2012 SRV 121155228 - 5231501 fTLE

CERTIFICATE OF FORMATIOrSf OF

WHIPCORD INVESTORS, LLC

The undersigned authorized person hereby forms a limited liability company

under the Delaware Limited Liability Company Act and adopts as the Certificate of Formation of

such limited liability company the foUovring;

1. The name of the Company:

Whipcord Investors, LLC

2. The name and address ofthe re^stered agent and office ofthe Company

in Delaware: c/o The Corporation Trust Company, Corporation Trust Center, 1209 Orange

Street, Wilmington, Delaware 19801, County of New Castle.

IN WITNESS WHEREOF, the\indersigned has duly executedthis Certificate of Formation on this 23rd day of October, 2012.

0R.GAK12ER:

Person

{J 1692326.1}

CERTIFrCATE OF AMENDMENT

TO

CERTIFICATE OF FORMATION

OF

WHIPCORD INVESTORS, LLC

s t a t e of Delavaie S e c r e t a w of S ta te

EtLvision' o f C o r p o r a t i o n s D e U v a x e d 0 9 : 3 9 AM 10 /24 /2012

fTLED 0 9 : 2 0 AM 10 /24 /2012 s p y 121159541 - 5231501 FILE

It is hereby certified that:

I. The name ofthe limited liability company (hereinafter called the "Company") is Whipcord Investors, LLC.

2. The Certificate of Fonnation ofthe Company is hereby amended by striking out Article FIRST thereof and by substituting in lieu of said Article the following new Article FIRST:'

'The name ofthe limited liability company (hcrciaafier called the "Company^ is Stadium Casino Investors, LLC."

3. The amendment of the Certificate of Fonnation herein certified has been duly adopted in accordance with the provisions of Section 18-202 ofthe Delaware Limited Liability Company Act

Executed as ofthe 23"* day of October. 2012.

WHrPCORD INVESTORS. LLC

By: i ' lny^jLcA^ z Cynthia LTWoolheater, Organizer

(Jlfi92S64,I}

^

»

18

i

• APPENDIX 18

CURRENT OWNERSHIP TABLE OF ORGANIZATION.

{L049752I.I}

4849-1441-8705.1

»

19

APPENDIX 19

FUNCTIONAL TABLE OF ORGANIZATION FOR APPLICANT WITH, JOB DESCRIPTIONS, AND NAMES OF EMPLOYEES EARNING IN EXCESS OF $250,000 IN ANNUAL COMPENSATION.

7J^_M.~ • ' l '^ . '^ . >-7 \ - • * . % ! , • • • .

m^t^'"^'^'^'-:

''•• •' ' 3;'*.,fr^Vi=^J^V-.'\' -.

• • < - • • ' 1 ^ 7 . ' ,.::,ijt ' % 7 : ' ''- .•'• ' . . - ^ - ^ • ' • . * . - - - • " •

, '-:vi„.^"l 'W,Wiicl5i-j ' i , . , , '• cv_i,'

v . - 7-,^77

.J- , .;;...

{L0497521;l}

APPENDIX 20

COPIES OF FEDERAL ENTITY TAX FILINGS, INCLUDING FORMS 1120, 1120-S, 1120-F, 1065, 941 AND ALL OTHER BUSINESS RELATED TAX FORMS FILED WITH THE IRS IN THE LAST FIVE (5) YEARS.

{U)497521.i;

»

•

21

» APPENDIX 21

COPIES OF 5500 FORMS FILED WITH THE IRS IN THE LAST FIVE (5) YEARS.

»

•

{L0497521.1}

>

i

22

f APPENDIX 22

DESCRIBE CRIMINAL HISTORY OF APPLICANT. THIS INFORMATION MUST BE PROVIDED IN ADDITION TO THE EMFORMATION PROVIDED IN SCFIEDULE 23. NARRATIVE INFORMATION ABOUT THE NATURE OF CHARGE OR COMPLAINT AND THE DISPOSITION MUST BE PROVIDED.

Does Not Apply

»

{UM9752I.I}

y

»

23

f APPENDIX 23

PURSUANT TO §1312 OF THE GAMING ACT, THE BOARD MAY NOT APPROVE AN APPLICATION FOR LICENSURE IF ANY OF ITS PRINCIPALS DO NOT MEET THE CHARACTER REQUIREMENTS OF §1310, ELIGIBILITY REQUIREMENTS, OR PURCHASES A CONTROLLING INTEREST IN A LICENSED GAMING ENTITY IN VIOLATION OF §1328.

HAS THE APPLICANT DIVESTED ALL INTERESTS THAT WOULD PROHIBIT LICENSURE AND ELIMINATED ANY PRINCIPAL WHO DOES NOT MEET THE CHARACTER OR ELIGIBILITY REQUIREMENTS? IF NOT, PROVIDE AN EXPLANATION. IF IT DOES NOT APPLY, WRITE DOES NOT APPLY IN RESPONSE TO THIS APPENDIX.

Yes.

i

»

{L049752I-I}

^£i>

»

»

i 24

I APPENDIX 24

PURSUANT TO §1330 OF THE GAMING ACT, NO LICENSEE, ITS AFFILIATE, INTERMEDIARY, SUBSIDIARY OR HOLDING COMPANY MAY POSSESS AN OWNERSHIP OR FINANCIAL INTEREST THAT IS GREATER THAN 33.3% OF ANOTHER SLOT MACHINE LICENSEE OR PERSON ELIGIBLE TO APPLY FOR A CATEGORY 1 LICENSE, ITS AFFILIATE, INTERMEDIARY, SUBSIDIARY OR HOLDING COMPANY.

DOES THE APPLICANT POSSESS AN OWNERSHIP OR FINANCL\L INTEREST THAT IS GREATER THAN 33.3% OF ANOTHER SLOT MACHINE LICENSEE OR PERSON ELIGIBLE TO APPLY FOR A CATEGORY 1 LICENSE, ITS AFFILIATE, INTERMEDL\RY, SUBSIDIARY OR HOLDING COMPANY? PROVIDE AN EXPLANATION OR WRITE "DOES NOT APPLY".

See the Application and Disclosure Information form of Stadium Casino, LLC at Appendix 24.

{L049752I.I}

»

i

i

25

• APPENDIX 25

PURSUANT TO §1512 OF THE GAMING ACT, NO EXECUTIVE-LEVEL STATE EMPLOYEE, PUBLIC OFFICL\L, PARTY OFFICER OR IMMEDIATE FAMILY MEMBER THEREOF SHALL HAVE A FINANCIAL INTEREST IN GR BE EMPLOYED, DIRECTLY OR INDIRECTLY, BY ANY LICENSED RACING ENTITY OR LICENSED GAMING' ENTITY, OR- ANY HOLDING, AFFILL\TE, INTERMEDIARY OR SUBSIDL^Y COMPANY, THEREOF, OR ANY SUCH APPLICANT.

HAS ANY PUBLIC OFFICIAL OR OTHER PROHIBITED PERSON POSSESSED A FINANCIAL INTEREST IN OR BEEN EMPLOYED DIRECTLY OR.INDIRECTLY BY THE APPLICANT OR RELATED ENTITY AT OR FOLLOWING THE EFFECTIVE DATE OF THE PA GAMING ACT?

{L0497521.]}

26

>

»

>

APPENDIX 26

PURSUANT TO §1313 OF THE GAMING ACT, PROVIDE INFORMATION, DOCUMENTATION AND ASSURANCES DEMONSTRATING THAT THE APPLICANT HAS SUFFICIENT BUSINESS ABILITY .AND EXPERIENCE TO CREATE AND MAINTAIN A SUCCESSFUL, EFFICIENT OPERATION. ALSO PROVIDE BIOGRAPHIES OF THE KNOWN IKDFVIDUALS WHO WILL PERFORM EXECUTIVE MANAGEMENT DUTIES AND PROVIDE vNAMES" OF ALL PROPOSED KEY EMPLOYEES AND A DESCRIPTION OF THEIR.RESPECTIVE OR PROPOSED RESPONSIBILITIES AS THEY BECOME KNOWN.

>

{L049752I.t}

1 i 27

>

>

APPENDIX 27

PURSUANT TO §1207(16) OF THE GAMTNG ACT, THE LICENSEE MUST SELL PENNSYLVANIA STATE LOTTERY TICKETS. AT ITS FACILITY AS NEAR AS PRACTICABLE TO THE PAY "WINDOWS. PROVIDE A PROPOSED FLOOR PLAN SPECIFYING THE' LOCATIONS WHERE STATE LOTiTERY TICKETS WILL BE SOLD AND. THE PROXIMITY OF THOSE LOCATIONS TO PAY WINDOWS. (NOTE: THIS SUBMISSION MUST BE FINALIZED ANT) APPROVED BY THE BOARD PRIOR TO OPERATION).

•'•• *:u;vJ^--^./ •'- , ••

.-'J:..,>.«••.•.\.,;i-4^,.,. J. ^/.....Mi ,••1,. - . , . - . . . .

A ''i .••••

' • ' •< ; . ' i ' . ^ ' y • , •'

:(L(M9752l.t}

>

28

»

>

• APPENDIX 28

PROVIDE A LIST OF ANY HOSPITAL, PLACE OF WORSHP. SCHOOL, CHARITABLE INSTITUTION, PARK, ZOO OR ANY SIMILAR PLACE FREQUENTED BY THE PUBLIC WITHIN 1500 FEET OF THE PROPOSED FACILITY.

PROVIDE A LIST OF ANY HOSPITAL, PLACE OF WORSHIP, SCHOOL, CHARITABLE INSTITUTION. PARK, ZOO OR ANY SIMILAR PLACE FREQUENTED BY THE PUBLIC WITHIN 1500 FEET OF THE PROPOSED FACILITY.

Applicant interprets this appendix as being directed to the operating applicant, Stadium Casino, LLC, and therefore the information requested Does Not Apply.

>

r {L049752I.I!

>

29

>

}

APPENDIX 29

SUBMIT AN INITIAL NARRATIVE DESCRIPTION OF PROPOSED ADMINISTRATIVE AND ACCOUNTING PROCEDURES, INCLUDTNG A WRITTEN SYSTEM OF INTERNAL CONTROL, PURSUANT TO §1322 OF TFIE GAMING ACT (NOTE: THIS SUBMISSION MUST BE FINALIZED AND APPROVED BY THE BOARD PRIOR TO OPERATION).

{L049752i,Il

APPENDIX 30

PROVIDE MARKETING PLANS AND PROPOSALS AND DETAILS OF THE PROXIMITY OF THE FACILITY TO ITS MARKETING SERVICE AREA.

y

(L049752I.!}

APPENDIX 31

PROVIDE COPIES OF LOCAL ZONING AND LAND USE APPROVALS OR A DETAILED EXPLANATION OF THE STATUS OF THE REQUEST WITH COPIES OF ALL FILINGS.

Applicant interprets this appendix as being directed to the operating applicant, Stadium Casino, LLC, and therefore the information reiquested Does Not Apply.

(L049752I.1}

APPENDIX 32

PURSUANT TO §1322 OF THE GAMING ACT AND/OR BOARD REGULATIONS, SUBMIT A COMPLETE PROPOSED SITE PLAN OF THE PROPOSED LICENSED FACILITY, INCLUSIVE OF TRAFFIC STUDIES AND THE PARKING PLAN, INCLUDING THE NUMBER OF PARKING SPACES, ACCOMPANIED "BY ARCHITECTURAL DRAWINGS AND A PROPOSED GAMING FLOOR LAYOUT. THE GAMING FLOOR LAYOUT SHOULD CLEARLY DELINEATE THE SQUAREFOOTAGE OF THE AREA TO BE USED FOR THE PLACEMENT OF SLOT MACHINES AND TABLE GAMES AS WELL AS'TFIE SQUARE FOOTAGE OF THE AREA THAT WILL NO'i' BE USED FOR THE PLACEMENT OF SLOT MACHINES AND TABLE GAMES. FURTHER, THE GAMING FLOOR LAYOUT SHOULD DELINEATE THE SQUARE FOOTAGE RESERVED FOR ADDITIONAL SLOT MACHINES AND TABLE GAMES PERMITTED PURSUANT TO §1210 AND §13A110F THE GAMING ACT. PURSUANT TO §1210, PROVIDE DETAILS OF THE PROPOSED LOCATION OF SLOT MACHINES AND TABLE GAMES AT THE FACILITY AND THE NUMBER OF SLOT MACHINES AND TABLE GAMES REQUESTED. PURSUANT TO §1207 OF THE GAMING ACT, PROPOSED SURVEILLANCE CAMERA LOCATIONS BOTH WITHIN AND OUTSIDE THE PROPOSED LICENSED FACILITY SHOULD ALSO BE CLEARLY DELINEATED ON THE GAMING FLOOR LAYOUT AS WELL AS PROPOSED SECURITY ZONES ON THE GAMING FLOOR AND WITHIN AND OUTSIDE THE LICENSED FACILITY. (NOTE: THE SITE PLAN, GAMING FLOOR LAYOUT AND RELATED SURVEILLANCE AND SECURITY PROPOSALS MUST BE FINALIZED AND APPROVED BY THE BOARD PRIOR TO OPERATION).

(L049752I.I}

APPENDIX 33

PROVIDE DETAILS OF PLANNED RETAIL AND FOOD VENUES FOR THE FACILITY AND THE IDENTIFICATION OF THE OPERATORS OF EACH RETAIL FOOD VENUE.

, \

{L049752I.I}

APPENDIX 34

PROVIDE A LOCAL IMPACT REPORT, ENGINEERING REPORTS AND TRAFFIC STUDIES, INCLUDING DETAILS OF ANY ADVERSE IMPACT ON TRANSPORTATION, TiOKNSIT ACCESS, HOUSING, WATER AND SEWER.SYSTEMS, LOCAL POLICE AND EMERGENCY SERVICE CAPABILITIES, EXISTING TOURISM, INCLUDING HISTORICAL AND CULTURAL RESOURCES OR OTHER MUNICIPAL SERVICE OR RESOURCE. A COPY OF THE LOCAL IMPACT REPORT SHALL BE PROVIDED TO EACH POLITICAL SUBDIVISION IN WHICH THE LICENSED FACILITY WILL BE LOCATED. AT LEAST SEVEN (7) DAYS PRIOR TO THE' FILING OF THE APPLICATION FOR A SLOT MACHINE LICENSE. THE APPLICANT SHALL FILE A PROOF OF SERVICE WITH THE BOARD.


{L0497521.i}

APPENDIX 35

PROVIDE DETAILS OF LAND ACQUISITION COSTS.

{L049752I.ll

http://%7bL049752I.ll

APPENDIX 36

PROVIDE DETAILS OF A COMPULSIVE OR PROBLEM GAMBLING PLAN.


{L0497521,I}

APPENDIX 37

IF A TEMPORARY FACILITY IS TO BE LICENSED, PROVIDE DETAILS OF THE TEMPORARY FACILITY AS WELL AS A PLAN FOR HOW THE LICENSEE WILL TRANSITION TO A PERMANENT FACILITY, INCLUDING A DATE FOR THE COMPLETION OF THE PERMANENT FACILITY.

(L049752I.I}

i

\

38

APPENDIX 38

AS REQUIRED BY §1325 OF THE GAMING ACT, APPLICANT MUST ADDRESS EACH ITEM LISTED IN THIS SECTION. IF AN ITEM DOES NOT APPLY, THE APPLICANT MUST STATE THAT IN RESPONSE TO EACH ITEM LISTED. PROVIDE A PLAN, WITH DETAILS, FOR THE FOLLOWING:

(1) THE LOCATION AND QUALITY OF THE PROPOSED FACILITY, INCLUDING, BUT NOT LIMITED TO, ROAD AND TRANSIT ACCESS, PARKING AND CENTRALITY TO MARKET SERVICE AREA;

(2) THE POTENTIAL FOR NEW JOB CREATION AND ECONOMIC DEVELOPMENT WHICH WILL RESULT FROM GRANTING A LICENSE TO THE APPLICANT;

(3) THE APPLICANTS GOOD FAITH PLAN TO RECRUIT, TRAIN AND UPGRADE DIVERSITY IN ALL EMPLOYMENT CLASSIFICATIONS IN THE FACILITY;

(4) THE APPLICANTS GOOD FAITH PLAN FOR ENHANCING THE REPRESENTATION OF DIVERSE GROUPS IN THE OPERATION OF ITS FACILITY THROUGH THE OWNERSHIP AND OPERATION OF BUSINESS ENTERPRISES ASSOCIATED WIFH OR UTILIZED BY ITS FACILITY OR THROUGH THE PROVISION OF GOODS OR SERVICES UTILIZED BY ITS FACILITY AND THROUGH THE PARTICIPATION IN THE OWNERSHIP OF THE APPLICANT. PROVIDE SPECIFIC INFORMATION REGARDING THE DIVERSITY IN OWNERSHIP OF THE APPLICANT, I.E. MINORITIES, WOMEN;

(5) THE APPLICANTS GOOD FAITH EFFORT TO ASSURE THAT ALL PERSONS ARE ACCORDED EQUALITY OF OPPORTUNITY IN EMPLOYMENT AND CONTRACTING BY IT AND ANY CONTRACTORS, SUBCONTRACTORS, ASSIGNEES, LESSEES, AGENTS, GAMING SERVICE PROVIDERS AND SUPPLIERS IT MAY EMPLOY DIRECTLY OR INDIRECTLY;

(6) THE HISTORY AND SUCCESS OF THE APPLICANT IN DEVELOPING TOURISM FACILITIES ANCILLARY TO GAMING DEVELOPMENT, IF APPLICABLE TO THE APPLICANT;

(7) THE DEGREE TO WHICH THE APPLICANT PRESENTS A PLAN FOR THE PROJECT WHICH WILL LIKELY LEAD TO THE CREATION OF QUALITY, LIVING-WAGE JOBS AND FULL-TIME:PERMANENT JOBS FOR RESIDENTS OF THIS COMMONWEALTH GENERALLY AND FOR RESIDENTS OF THE HOST POLITICAL SUBDIVISION IN PARTICULAR;

(8) THE RECORD OF THE APPLICANT AND ITS DEVELOPER IN MEETING COMMITMENTS TO LOCAL AGENCIES, COMMUNITY-BASED ORGANIZATIONS AND EMPLOYEES IN OTHER LOCATIONS;

(9) TME DEGREE TO WHICH POTENTIAL ADVERSE EFFECTS WHICH MIGHT RESULT FROM THE PROJECT, INCLUDING COSTS OF MEETING THE INCREASED DEMAND FOR PUBLIC HEALTH CARE, CHILD CARE, PUBLIC TRANSPORTATION, AFFORDABLE HOUSING AND SOCIAL SERVICES, WILL BE MITIGATED;

(10) THE RECORD OF THE APPLICANT AND ITS DEVELOPER REGARDING COMPLIANCE V HTH (I) FEDERAL, STATE AND LOCAL DISCRIMINATION, WAGE AND HOUR, DISABILITY AND OCCUPATIONAL AND ENVIRONMENTAL HEALTH AND SAFETY LAWS AS WELL AS (II) STATE AND LOCAL LABOR RELATIONS AND EMPLOYMENT LAWS; (UI) THE APPLICANTS RECORD IN DEALING WITH ITS EMPLOYEES AND THEIR REPRESENTATIVES AT OTHER LOCATIONS.


{L0497521.1)

APPENDIX 39

PROVIDE INFORMATION DEMONSTRATING ADEQUATE FINANCING- FOR THE PROPOSED FACILITY AND TERMS OF FINANCING INCLUDING PAYBACK PERIOD.

i

i ,{L049752l.l}

»

40

¥ APPENDIX 40

PROVIDE BUSINESS AND ECONOMIC DEVELOPMENT PLANS AND TIMETABLES, PROJECTED DEBT SERVICE EXPENSES, PROJECTED EBITDA AND INTERNAL RATE OF RETURN, PROJECTED ANNUAL GROSS TERMINAL REVENUE, PROJECTED OPERATING AND CAPITAL EXPENSES AND DEFINED GAMING MARKET AND PROJECTED VISITATION.

{L049752I.I)

»

41

I APPENDIX 41

PROVIDE LETTERS OF REFERENCE FROM LAW ENFORCEMENT AGENCIES HAVING JURISDICTION IN THE APPLICANrS AND. PRINCIPAL'S MAIN PLACE OF RESIDENCE AND PLACE OF BUSINESS INDICATING THAT THE AGENCY DOES NOT HAVE ANY PERTINENT INFORMATION RELATING TO THE APPLICANT OR ITS PRINCIPALS. IF THE LAW ENFORCEMENT AGENCY HAS INFORMATION PERTAINING TO THE APPLICANT OR ITS PRINCIPALS, THE LETTER SHALL SPECIFY THE DETAILS OF THE INFORMATION.

IF NO LETTERS ARE RECEFVED WTIHIN 30 DAYS OF THE REQUEST, THE APPLICANT OR PRINCIPAL MAY SUBMIT A SWORN OR AFFIRMED STATEMENT THAT THE APPLICANT OR PRINCIPAL IS A CITIZEN IN GOOD STANDING m HIS JURISDICTION OF RESIDENCE AND PRIMARY PLACE OF BUSINESS.

{L049752I.I}

»

42

»

APPENDIX 42

IF THE APPLICANT HAS HELD A GAMING LICENSE IN ANY XURISDICTION, PROVIDE A LETTER OF REFERENCE FROM THE GAMING OR CASINO ENFORCEMENT OR REGULATORY AGENCY IN THE OTHER JURISDICTION, SPECIFYING THE EXPERIENCES OF THE AGENCY WITH THE APPLICANT, THE APPLICANT'S ASSOCIATES AND THE APPLICANT'S GAMING OPERATION.

IF NO LETIER IS RECEIVED WITHIN 30 DAYS OF REQUEST BY THE APPLICANT, THE APPLICANT MAY SUBMIT A SWORN OR AFFIRMED STATEMENT THAT THE APPLICANT'S OPERATION IS IN GOOD STANDING WITO THE REGULATORY AGENCY.

{L0497521,l}

>

•

43

r APPENDIX 43

PROVIDE AN ORIGINAL PAYMENT BOND OR AN ORIGINAL IRREVOCABLE LETTER OF CREDIT THAT INCLUDES A DRAW CERTIFICATE, AT THE APPLICANT'S OPTION, GUARANTEEING THE APPLICANT'S PAYMENT OF THE SLOT MACHINE LICENSE FEE REQUIRED BY §1209 (FOR CATEGORY 1 AND 2) AND §1305 (CA'IEGORY 3) OF THE GAMING ACT.

{L0497S2I.I}

»

»

44

»

APPENDIX 44

PROVIDE A CHART OF EXISTING GAMING SERVICE PROVIDERS INCLUDING THE NAME, ADDRESS, PHONE AND TAX IDENTIFICATION NUMBER OF THE GAMING SERVICE PROVIDERS, TYPES OF GOODS AND/OR SERVICES PROVIDED BY THE GAMING SERVICE PROVIDERS, TOTAL DOLLAR AMOUNT OF BUSINESS WITH GAMING SERVICE PROVIDERS IN THE PAST TWELVE (12) MONTHS AND TOTAL DOLLAR AMOUNT OF BUSINESS EXPECTED TO BE CONDUCTED WITH GAMING SERVICE PROVIDERS TN THE NEXT TWELVE (12) MONTHS.

* GAMING SERVICE PROVIDERS IS DEFINED IN 58 PA. CODE §401A.3.

i , •.ti*'i. '•' ••''' • 7 ' i - . ' v . •• '.=- •'' ": w i^f--'*ii

; ' • ; " " • ; ; ' " ; < \ t . . . t ^ ' '

{L049752I.I>

\

\

45

APPENDIX 45

PROVIDE A SUMMARY OF ALL PERSONS WHO HOLD AN OWNERSFflP OR OTHER BENEFICLAL INTEREST IN THE APPLICANT AND ANY SUCH INTEREST IN ANY OF ITS PRINCIPAL AFFILIATES OR PRINCIPAL ENTITIES REQUIRED TO" BE LICENSED OR PERMITTED IN PENNSYLVANIA; PROVIDED HOWEVER, IF ANY OF THE ENTITIES ARE PUBLICLY TRADED, ONLY INTERESTS EQUAL TO OR EXCEEDING FIVE PERCENT MUST BE DISCLOSED. OWNERSHIP INTEREST SHOULD BE PROVIDED IN A MANNER CONSISTENT WITH THE OV/NERSHIP INTEREST REPORT FOUND ON THE BOARD'S WEBSITE UNDER LICENSURE/REPORTS AND GENERAL INFORMATION.

See the Application and Disclosure Information form of Stadium Casino, LLC at Appendix 45.

s.--n

{L049752I.1)

SLOT OPERATOR AND MANAGEMENT COMPANY- APPLICATION AND DISCLOSURE

Documents

Transcript of SLOT OPERATOR AND MANAGEMENT COMPANY- APPLICATION AND DISCLOSURE