PREMIER LEAGUE

PREMIER LEAGUE
OWNERS’ AND DIRECTORS’ DECLARATION (Rules A.1.44, F.2 and F.3)
To: The Secretary
The Premier League
I, (full name)
of (address)
(postcode)
hereby declare that:
1. I am/propose to become* a Director of Football Club;
2. I am/am not* a person having Control over the Club;
3. I am/am not* either directly or indirectly involved in or have power to determine or influence the
management or administration of another Club or Football League club;
4. I hold/do not hold* either directly or indirectly a Significant Interest in a Club while either directly
or indirectly holding an interest in any class of Shares of another Club;
5. I am/am not* prohibited by law from being a Director;
6. I have/have not* been convicted of an offence set out in Premier League Rule F.1.4;
7. I have/have not* made an Individual Voluntary Arrangement or been the subject of an Interim
Bankruptcy Order, a Bankruptcy Restriction Order or a Bankruptcy Order;
8. I have/have not*been a Director of a Club or club which, while I have been a Director of it, suffered
2 or more unconnected Events of Insolvency;
9. I have/have not*been a Director of 2 or more Clubs or clubs each of which, while I have been a
Director of them, has suffered an Event of Insolvency;
10. I am/am not* subject to a suspension or ban from involvement in the administration of a sport as
set out in Rule F.1.8;
11. I am/am not* subject to any form of suspension, disqualification or striking-off by a professional
body as set out in Rule F.1.9;
12. I am/am not* required to notify personal information pursuant to Part 2 of the Sexual Offences Act 2003;
13. I have/have not*been found to have breached any of the rules set out in Rule F.1.11;
14. this Declaration is true in every particular.
I consent pursuant to Schedule 2 and Schedule 3 of the Data Protection Act 1998 to the Football Association
Premier League Limited holding and processing the above personal data and sensitive data for the purpose of
discharging its functions as a regulatory and governing body of football.
I understand that the words “Bankruptcy Order”, “Bankruptcy Restriction Order”, “Club”, “club”, “Control”,
“Declaration”, “Director”, “Event of Insolvency”, “Holding”, “Individual Voluntary Arrangement”, “Interim
Bankruptcy Restriction Order”, “Shares” and “Significant Interest” (together with any other defined terms
comprising any part of these definitions) have the meanings set out in the Rules of the Premier League.
* delete as appropriate
Signed by the Director
Date
Signed by an Authorised Signatory
Date
Form 4
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PREMIER LEAGUE FORMS