FILE IN DUPLICATE
Please mail completed renewal application to: Oklahoma Secretary of State, 2300 N Lincoln
Blvd, Room 101, Oklahoma City, Oklahoma 73105.
Pursuant to 70 O.S. Sec. 821.61 et seq., the undersigned hereby submits the following application for
renewal of registration:
THIS REGISTRATION IS VALID UNTIL THE FIRST JUNE 30 FOLLOWING THE DATE
Name of Applicant:
Applicant is: ( ) an individual; ( ) a company; ( ) a corporation; ( ) an association;
( ) a partnership; ( ) other legal entity.
If Applicant is other than an individual, list the name of each field agent and complete
the applicable information on each agent.
If necessary, attach addendum with appropriate information.
Address of the Applicant's principal place of business:
Names and addresses of all athletes for whom the athlete agent is currently performing
professional services not included in the initial registration application:
Names and addresses of all persons, except bona fide employees on stated salaries, who are
financially interested as partners, associates or profit sharers in the operation of the business of the
athlete agent not included in the initial registration application:
Signature of Applicant
(SOS FORM 93-07/2005)