Application For Registration/renewal As An Athlete Agent - Secretary Of State - State Of Iowa

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Application for
MICHAEL A. MAURO
Registration/Renewal
Secretary of State
as an Athlete Agent
State of Iowa
Iowa Code Chapter 9A
Registration Procedure
1. Complete the form below. Return the completed form to the Secretary of State’s Office.
2. 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 submitted an application in the form prescribed by the Secretary of State.
The Secretary of State shall accept the application and the certificate from the other state as
an application for registration in this state if the application to the other state complies with
all of the following:
a. Was submitted in the other state within the 6 month period immediately
preceding the submission of the application in this state and the applicant
certifies that the information contained in the application in the other state is
current.
b. Contains information substantially similar to or more comprehensive than that
required in an application submitted in this state.
c. Was signed by the application under penalty of perjury.
3. The original certificate of registration or a renewal of a certificate of registration is valid for 2
years from the date of issuance.
Complete the following (please type or print):
Attach additional pages if more space is needed.
1. This application represents:
First Time Application – Fee: $500
Renewal – Fee: $500
2. Name of applicant:
3. Address of the applicant’s principal place of business:
4. Name of the applicant’s business or employer (if applicable):
Application for Registration/Renewal of Athlete Agent
Page 1 of 4

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