Regulations on Working With Intermediaries
24 March 2015 10| Page
contractual relationship with FFA, leagues, associations, confederations or FIFA exists in connection
with my activities as an intermediary.
I declare, pursuant to clause 6.6 of FFA’s Regulations on Working with Intermediaries, that I shall not accept
any payment to be made by one club to another club in connection with a transfer, such as transfer
compensation, training compensation or solidarity contributions.
I declare, pursuant to clauses 6.1 and 6.2 of FFA’s Regulations on Working with Intermediaries, that I shall not
accept any payment from any party if the player concerned is a minor, as defined in point 11 of the
Definitions section of FIFA’s Regulations on the Status and Transfer of Players.
I declare that I shall not take part in, either directly or indirectly, or otherwise be associated with, betting,
gambling, lotteries and similar events or transactions connected with football matches. I acknowledge
that I am forbidden from having stakes, either actively or passively, in companies, concerns,
organisations, etc. that promote, broker, arrange or conduct such events or transactions.
I consent, pursuant to clause 5.2 of FFA’s Regulations on Working with Intermediaries, to the association
obtaining full details of any payment of whatsoever nature made to me by a club or a player for my
services as an intermediary.
I consent, pursuant to clause 5.3 of FFA’s Regulations on Working with Intermediaries, to the leagues,
associations, confederations and/or FIFA obtaining, if necessary, for the purpose of their
investigations, all contracts, agreements and records in connection with my activities as an
intermediary. Equally, I consent to the aforementioned bodies also obtaining any other relevant
documentation from any other party advising, facilitating or taking any active part in the negotiations
for which I am responsible for the purpose of their investigations.
I consent, pursuant to clause 5.1 of FFA’s Regulations on Working with Intermediaries, to FFA holding,
processing and publishing any data for the purpose of their publication.
I consent, pursuant to clause 8.4 of FFA’s Regulations on Working with Intermediaries, to FFA publishing
details of any disciplinary sanctions taken against me and informing FIFA accordingly.
I am fully aware and agree that this declaration shall be made available to the members of the competent
bodies of FFA.
I consent to the collection, use and disclosure of my personal information as described in this declaration and
FFA’s Regulations on Working with Intermediaries.
I make this solemn declaration in good faith, the truth of which is based on the information and materials
currently available to me, and agree that FFA is entitled to undertake such checks as may be necessary to
verify the information contained in this declaration. I also acknowledge that, having submitted this declaration,
in the event that any of the above-mentioned information changes, I must notify FFA immediately.
(Print Name) (Signature)
(Place and date)
(Witness Name) (Witness Signature)
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