Please write all card names completely and legibly. Please include the quantity for each card.

Full Name: Date:

Judge Use Only:

E
Last Initial

M M / D D / Y Y Y Y
Main Deck Total

Konami Player ID:

Event:

Monster Cards

Spell Cards

Trap Cards

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<<< Total Spell Cards

<<< Total Trap Cards

Side Deck

Extra Deck

For Judge Use Only

Deck List Checked? Judge Initial Description: Infraction(s):

Deck Check Rd: Judge Initial Description: Infraction(s):

Deck Check Rd: Judge Initial Description: Infraction(s):

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<<< Total in Extra Deck