Regulations on Working With Intermediaries
I declare, pursuant clause 6.6 of FFA’s Regulations on Working with Intermediaries, that neither the company I
represent nor I shall 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 neither
the company I represent nor I shall 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 neither the company I represent nor I shall 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 both the company I represent and I myself are forbidden from
having stakes, either actively or passively, in companies, concerns, organisations, etc. that promote,
broker, arrange or conduct such events or transactions.
On behalf of the company I represent, I consent, pursuant to clause 5.2 of FFA’s Regulations on Working with
Intermediaries, to the associations obtaining full details of any payment of whatsoever nature made to
the company by a club or a player for its services as an intermediary.
On behalf of the company I represent, 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 the
activities as an intermediary of the company. 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 the company I represent is responsible for the purpose of
their investigations.
On behalf of the company I represent, 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.
On behalf of the company I represent, I consent, pursuant to clause 8.4 of FFA’s Regulations on Working with
Intermediaries, to FFA publishing and informing FIFA of any disciplinary sanctions taken against the
company I represent.
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
for the purposes set out in FFA’s privacy policy (available at www.ffa.com.au), including administering
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.
______________________________ ________________________________
(Authorised Representative Name) (Authorised Representative Signature)
______________________________
(Place and date)
______________________________ _________________________________
(Witness Name)
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