Form 2504—General Information (Statement of Individual Agents) The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary Athlete agents are governed by Chapter 2051 of the Texas Occupations Code and the secretary of state’s administrative rules found in 1 Texas Administrative Code Chapter 78. Acting as an athlete agent in Texas requires registration with the secretary of state. Sections 2051.102–2051.104, Occupations Code and 78.1, Administrative Code, set forth the application requirements for athlete agent registration. Pursuant to sections 2051.104, Occupations Code and 78.1, Administrative Code, an application for renewal (Form 2505-I) must be accompanied by a list of the name and address of each individual who recruits or solicits an athlete to enter into an agent contract, a financial services contract, or a professional sports services contract with the applicant. This form may be used for the list and should be attached to the application for registration or renewal. An athlete agent must notify the secretary of state within 30 days of any change to the individuals identified in this list by submitting a statement showing the change. This form may also be used to submit an updated list. Instructions for Form A document on file with the secretary of state is a public record subject to public access and disclosure. When providing address information, use a business or post office box address rather than a residence address if privacy concerns are an issue. Revised 03/11 Form 2504 1 American LegalNet, Inc. www.FormsWorkFlow.com Form #2504 Rev. 03/2011 Submit with Form 2505-I. For update, submit to: SECRETARY OF STATE Statutory Documents Section P O Box 13550 Austin, TX 78711-3550 512-463-5705 512-475-2815 – Fax Filing Fee: None. This space reserved for office use STATEMENT OF INDIVIDUAL AGENTS Athlete Agent/Applicant: Identify each individual who recruits or solicits an athlete to enter into an agent contract, professional sports contracts, or financial services contract with the above-named athlete agent or applicant. Name: Address: Street City State Zip Street City State Zip Street City State Zip Street City State Zip Street City State Zip Street City State Zip Street City State Zip Street City State Zip Street City State Zip Name: Address: Name: Address: Name: Address: Name: Address: Name: Address: Name: Address: Name: Address: Name: Address: USE AN ADDITIONAL SHEET IF NECESSARY Form 2504 2 American LegalNet, Inc. www.FormsWorkFlow.com