State of New Mexico s4

S U B M I T C O M P L E T E P A C K A G E T O G C B - P R O M O T I O N S @ S T A T E . N M . US O R M A I L T O : A N G E L A V . G A R C I A , A D M I N I S T R A T I V E A S S I S T A N T A U D I T A N D C O M P L I A N C E D I V I S I O N N E W M E X I C O G A M I N G C O N T R O L B O A R D 4 9 0 0 A L A M E D A B O U L E V A R D N E A L B U Q U E R Q U E , N E W M E X I C O 8 7 1 1 3 - 1 7 3 6 P H O N E : ( 5 0 5 ) 2 0 6 - 7 2 3 0

Additional Payout/Promotion/Personal Property Award Submission Form

This is being submitted as (check one): Additional Payout Promotion Personal Property Award Non Cash Top Prize Award Slot Tournament

Name of Advertisement: Run Dates: (Name these by the first 3 words of the ad- do not use casino name) (first advertisement date to final drawing/award date)

Category of Submittal This is a new submission. This is a notification of change in beginning and end dates of program. This is a notification that there are changes or modifications as to how the program shall be conducted.

Items to Review before Submitting

Submit to NMGCB 10 days prior to the first advertisement of this Promotion (NMGCB will use the date that this submission is received). Cash value of the additional payouts or cost of personal property award (write NA if this is a promotion): ______I have reviewed this ad to make certain that there is no reference or implied reference to alcohol as an enticement to game or reference to reduced price of food as an enticement to game in this ad. The responsible gaming message and the 1 (800) phone number appears on all advertisements. All non-profit advertising states: “For Member’s Only” (NA if non-applicable).

Mandatory Items to Submit a Complete Package

Copy of Rules attached. List of gaming machine license numbers participating in the submitted program. Copy of actual advertisement language (ad slick, poster, newspaper ad, magazine ad, artwork with actual copy and graphics) This form is complete and all required attachments are included.

New Mexico Gaming Control Board GC-26 (Additional Payout/Promotion/Personal Property Award Submission Form) Effective 03/09/05 Revised 6/10 S U B M I T C O M P L E T E P A C K A G E T O G C B - P R O M O T I O N S @ S T A T E . N M . US O R M A I L T O : A N G E L A V . G A R C I A , A D M I N I S T R A T I V E A S S I S T A N T A U D I T A N D C O M P L I A N C E D I V I S I O N N E W M E X I C O G A M I N G C O N T R O L B O A R D 4 9 0 0 A L A M E D A B O U L E V A R D N E A L B U Q U E R Q U E , N E W M E X I C O 8 7 1 1 3 - 1 7 3 6 P H O N E : ( 5 0 5 ) 2 0 6 - 7 2 3 0

Licensee Name: Licensee #: Submitted By: Print Your Name: Phone Number: E-Mail Address: All boxes must be checked or marked N/A if not applicable. Failure to submit any of the required items will cause submission to be rejected.

New Mexico Gaming Control Board GC-26 (Additional Payout/Promotion/Personal Property Award Submission Form) Effective 03/09/05 Revised 6/10