Athlete Agent Regulatory History

This application must be signed under penalty of perjury. Answer every question completely and accurately; omissions may be grounds for denial or revocation.

How your answers here affect your application type

Reciprocal eligibility is determined by the Division — not selected by you. Your prior-registration and discipline answers below are checked against Louisiana's approved-state list. Any disciplinary history (a “Yes” to a denial, suspension, revocation, or pending complaint) automatically disqualifies the reciprocal path and routes you to New Registration. Borderline cases (mixed or unverified states) go to a manual Division review queue, and no fee is charged until the Division approves your path.

TBD: derived-routing engine — admin-managed approved-states list, dynamic classification, and Division review queue (logged as a spec item).

Sanctions Caused to Athletes or Institutions

Has your conduct as an athlete agent ever resulted in a sanction or suspension imposed on an athlete or educational institution, or a declaration of ineligibility imposed on an athlete? *
For each: Athlete Name (if applicable) | Institution | Federation/Association | Date | Nature of Sanction | Outcome.

Agent Compliance Violations

Have you ever been convicted, reprimanded, censured, disqualified, cited, or disciplined for a violation of any state athlete agent statute? *
Are any charges or complaints regarding your conduct as an athlete agent currently pending?