PREMIER LEAGUE

PREMIER LEAGUE
Form 5
OWNERS’ AND DIRECTORS’ DECLARATION (Rules A.1.55, F.2 and F.3)
To:
The Secretary
The Premier League
PREMIER LEAGUE FORMS
I, (full name) of
(post code)
hereby declare that:
1. I am/propose to become* a Director of (the 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 hold/do not hold* either directly or indirectly a Significant Interest in a club (and in this
Declaration 5, Significant Interest shall be construed as if references to ‘the Club’ in that
definition at Rule A.1.151, were references to ‘the club’).
6. I am/am not* prohibited by law from being a director as set out in Rule F.1.3;
7. I have/have not* been Convicted of an offence set out in Premier League Rule F.1.4;
8. I have/have not* been the subject of any of the arrangements, orders, plans or provisions set out
in Rule F.1.5 or F.1.6;
9. I have/have not*
9.1 been a Director of a Club which, while I have been a Director of it, suffered 2 or more
unconnected Events of Insolvency;
9.2 been a Director of a Club which, while I have been a Director of it, suffered 2 or more
unconnected Events of Insolvency (and in this Declaration 9.2 the definitions of Director at
Rule A.1.56. and Events of Insolvency at Rule A.1.60. shall be construed as if references to
‘the Club’ in those definitions were references to ‘the club’);
10. 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 (and in this Declaration 9 the definitions of
Director at Rule A.1.56. and Events of Insolvency at Rule A.1.60. shall be deemed to apply to clubs
in the same way as to Clubs);
11. I am/am not* subject to a suspension or ban from involvement in the administration of a sport as
set out in Rule F.1.9;
12. I am/am not* subject to any form of suspension, disqualification or striking-off by a professional
body as set out in Rule F.1.10;
13. I am/am not* required to notify personal information pursuant to Part 2 of the Sexual Offences
Act 2003;
14. I have/have not*been found to have breached any of the rules set out in Rule F.1.12;
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