FG-710-4 (PA) TERMINATION OF FOREIGN GAMING BEFORE THE NEVADA GAMING COMMISSION AND THE STATE GAMING CONTROL BOARD COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No. : EXACT NAME OF NEVADA LICENSEE Plaintiff(s) -against- Calendar No. : In the Matter of JUDICIAL SUBPOENA : Foreign Gaming Operation Statement : : NAME OF FOREIGN GAMING OPERATION Defendant(s) : ......... .............. ............ ...... ......... FOREIGN. LOCATION .ADDRESS. (e.g.,. Tunica, Mississippi) TYPE OF GAMING (e.g., Casino, Riverboat) DATE THE PEOPLE OF THE STATE OF NEW YORK 1. The Nevada Licensee State the Nevada licensee’s name and address. TO 2. Affiliated Companies State the name(s) and address(s) of any affiliated company, holding company, intermediary company or publicly traded corporation GREETINGS: related to the Nevada licensee. YOU, that all business and excuses being laid aside, you and each of you attend before WE COMMAND 3. the Honorable Foreign Gaming Operation Statement located at County of in room , on the day of at the , 20 , Court , at o'clock in the noon, and at any recessed (a) Date foreign gaming and give evidence as a witness in this Date. the part of the or adjourned date, to testify participation terminated. action on (b) Reason(s) for termination of foreign gaming participation. Describe in detail the reason(s) for terminating participationis(e.g., property sold, agreement you liable to Your failure to comply with this subpoena punishable as a contempt of court and will make the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a terminated, or resultlonger a Nevada licensee). no of your failure to comply. The Nevada licensee shall keep the Board’s Corporate Securities Division of the Witness, Honorable , one of the Justices Court in County, , 20 promptly informed of all actions taken byday offoreign jurisdiction regarding the foreign the gaming operation and all matters directly or indirectly related thereto. (Attorney must sign above and type name below) Nevada Licensee Attorney(s) for By: Manual Signature___ Typed Signature Address Office and P.O. Title Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com