טופס מייצג – אנגלית להורדה, הדפסה ומילוי מקוון

Form Name: Declaration of Intermediary for Football Leagues

Purpose:
This form, titled "Declaration of Intermediary," serves as a formal declaration and agreement made by individuals or entities acting as intermediaries in the realm of professional football leagues. It outlines their commitments, responsibilities, and adherence to relevant laws and regulations governing their activities within the football industry.

Required Sections:

1. Personal Information:
- First name/s: _______________________
- Surname/s: _______________________
- I.D. No./s: _______________________
- Date of birth: _______________________
- Citizenship / citizenships: _______________________
- Full permanent address (including telephone and facsimile numbers and e-mail address): _______________________

(For body corporate intermediaries)
- Name of body corporate: _______________________
- Type of body corporate: _______________________
- Registration number of the body corporate: _______________________
- Address of body corporate: _______________________

2. Declarations and Undertakings:
- Commitment to comply with all applicable laws and Association bylaws, as well as FIFA rules and regulations regarding intermediary activities.
- Confirmation of no prior or current positions held within football associations or teams within the past 12 months.
- Declaration of no criminal convictions related to violence or financial matters.
- Assurance of no contractual relationships likely to cause a conflict of interests with League Administration, associations, confederations, or FIFA.
- Pledge not to accept payments related to player transfers, training, or solidarity payments in connection with the transactions in which they serve as agents.
- Agreement not to accept payments when representing minor players.
- Commitment to avoid illegal gambling and participation in legal gambling related to the players or teams they represent.
- Consent for the Association to receive details of payments received for their intermediary services.
- Agreement to transfer all relevant contracts, agreements, and records to the Association.
- Consent to the Association's publication of data from these agreements on its website.
- Acknowledgment that disciplinary penalties and measures taken against the intermediary will be reported and published.
- Consent for authorized bodies of the Association to have access to this declaration.
- Provision for additional relevant details.

3. Verification and Updates:
- Confirmation that the information provided is accurate based on current knowledge.
- Agreement to cooperate with any necessary investigations by the Association.
- Commitment to promptly notify the Association of any changes in the provided information.

Signature and Date: _______________________

Note: This form is intended for intermediaries involved in professional football leagues and outlines their commitment to ethical and legal standards in their role.