West Virginia Code § 30-39-5

Registration as athlete agent; form; requirements
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(a) An applicant for registration shall submit an application for registration to the Secretary
of State in a form prescribed by the Secretary of State. An application filed under this
section is a public record. The application must be in the name of an individual and, except
as otherwise provided in subsection (b) of this section, signed or otherwise authenticated by
the applicant under penalty of perjury and state or contain: e
(1) The name of the applicant and the address of the applicant's principal place of business;
(2) The name of the applicant's business or employer, if applicabule;
(3) Any business or occupation engaged in by the applicant for the five years next preceding
the date of submission of the application;
(4) A description of the applicant's:
(A) Formal training as an athlete agent;
(B) Practical experience as an athlete agent; and
(C) Educational background relating to the applicant's activities as an athlete agent;
(5) The names and addresses oef three individuals not related to the applicant who are willing
to serve as references;
(6) The name, sport and last known team for each individual for whom the applicant acted as
an athlete agent during the five years next preceding the date of submission of the
application;
(7) The names and addresses of all persons who are:
(A) With respect to the athlete agent's business if it is not a corporation, the partners,
members, officers, managers, associates or profit-sharers of the business; and
(B) With respect to a corporation employing the athlete agent, the officers, directors and any
shareholder of the corporation having an interest of five percent or greater;
(8) Whether the applicant or any person named pursuant to subdivision (7) of this subsection
has been convicted of a crime that, if committed in this state, would be a crime involving
moral turpitude or a felony and, identify the crime;
(9) Whether there has been any administrative or judicial determination that the applicant or
any person named pursuant to subdivision (7) of this subsection has made a false,
misleading, deceptive, or fraudulent representation;
(10) Any instance in which the conduct of the applicant or any person named pursuant to
subdivision (7) of this subsection resulted in the imposition of a sanction, suspension, or
declaration of ineligibility to participate in an interscholastic or intercollegiate athletic event
on a student-athlete or educational institution;
(11) Any sanction, suspension, or disciplinary action taken against the applicant or any
person named pursuant to subdivision (7) of this subsection arising out of occupational or
professional conduct; and e
(12) Whether there has been any denial of an application for, suspension or revocation of, or
refusal to renew, the registration or licensure of the applicant or any person named pursuant
to subdivision (7) of this subsection as an athlete agent in any stuate.
(b) An individual who has submitted an application for, and holds a certificate of, registration
or licensure as an athlete agent in another state, may submit a copy of the application and
certificate in lieu of submitting an application in the foarm prescribed pursuant to subsection
(a) of this section. The Secretary of State shall accept the application and the certificate
from the other state as an application for registratilon in this state if the application to the
other state: s
(1) Was submitted in the other state withini six months next preceding the submission of the
application in this state and the appglicant certifies that the information contained in the
application is current;
(2) Contains information substantially similar to or more comprehensive than that required
in an application submitted in this state; and
(3) Was signed by the applicant under penalty of perjury.

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