Fee: $1,000.00 PRINT CLEARLY APPLICATION FOR REGISTRATION OF ATHLETE AGENT Please mail completed registration application to: Oklahoma Secretary of State, 2300 N Lincoln Blvd, Room 101, Oklahoma City, Oklahoma 73105. Pursuant to Title 70 O.S. Sec. 821.61 et seq., the undersigned hereby submits the following application for registration: 1. Name of Applicant: A. Applicant is: ( ) an individual; ( ) a company; ( ) a partnership; ( ) a corporation; ( ) an association;( ) other legal entity. B. If Applicant is other than an individual, list the name of each field agent and complete the applicable information. C. 2. Name of Field Agent:
Address of the Applicant's principal place of business:
3. Business or occupation engaged in by Applicant for five (5) years preceding the date of this application:
Applicant's and/or Field Agent's: A. Formal Training:
B. Practical Experience:
C. Educational background in the subjects of contracts, contract negotiation, complaint resolution, arbitration or civil resolution of contract disputes, federal income taxation and federal estate planning:
Names and addresses of five (5) professional references:
6. Names and addresses of all athletes for whom the athlete agent is performing professional services:
7. Names and addresses of all athletes for whom the athlete agent has previously performed professional services, accompanied by a brief explanation of the reason the athlete agent is not currently performing professional services for the athletes.
8. Names and addresses of all persons, except bona fide employees on stated salaries, who are financially interested as partners, associates or profit sharers in the operation of the business of the athlete agent.
Signature of Applicant
(SOS FORM 92-10/00)