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Alexander Santiago EX-665 4920-2016

Create: Thu, 07/13/2023 - 22:13

Author: admin

Alexander

Santiago

EX-665

4920-2016

Tue, 03/21/2017 - 20:00

Alexander_Santiago.pdf127.63 KB

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NAME OF INDIVIDUAL FILING A DISPUTE OR COMPLAINT

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DATE AND APPROX TIME OF INCIDENT:

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USER/SCREEN NAME USED:

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Please provide a summary of the incident or dispute to the best of your knowledge. Include any statements which you made to the licensed gaming entity's personnel or any statements you made to witnesses to the incident or dispute.

Please provide a summary of the incident or dispute to the best of your knowledge. Include any statements which you made to the licensed gaming entity's personnel or any statements you made to witnesses to the incident or dispute.

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