Please Insert the Letterhead and Logo of the Former National Federation

(PLEASE INSERT THE LETTERHEAD AND LOGO OF THE FORMER NATIONAL FEDERATION)

CONFIRMATION LETTER BY

NAME OF THE FORMER NATIONAL FEDERATION

Date:

Dear Sirs,

Reference is made to the sport nationality of the Athlete:

The Athlete

First name:

Last name:

Date of birth:

Aquatic discipline:

We, (the “Federation”) hereby confirm that:

Registration with the Federation. (Please tick the appropriate box)

[ ] The Athlete has never been registered with the Federation.

[ ] The Athlete has been registered with the Federation from to . The Athlete has not been under the jurisdiction of the Federation for the last twelve (12) months from the Date of this letter.

Last representation with the Federation. (Please tick the appropriate box)

[ ] The Athlete has never represented the Federation in International Competitions*.

[ ] The Athlete has represented the Federation in International Competitions and the Athlete’s last representation with the Federation was:

Name of International Competition:
Date of the International Competition:

* “International Competition” means any competition organised or sanctioned by FINA, any Continental or Regional Organisation or any Member Federation in which other FINA recognised Federations, clubs or individuals participate. (FINA Rule GR 2.1)

Club Participation. (Please tick the appropriate box)

[ ] The Athlete has never participated with a club of the Federation.

[ ] The Athlete has been registered with a club of the Federation and competing for that club for the last twelve (12) months from the Date of this letter.

[ ] The Athlete has been registered with a club of another National Federation and competing for that club for the last twelve (12) months from the Date of this letter.

Additional information: .

Yours faithfully,

______

(Name and Signature of the Federation President and Official Stamp)

NB. This is an official statement of the National Federation. The National Federation hereby declares that above information is true and correct, and certify that has completed and read this document and know and understand the contents of it. The National Federation understands that any false statement on this application constitutes a perjury and could result in denial of the submitted request, and disciplinary proceedings with sanction of warning, fine, suspension or expulsion. The National Federation understands that all information on this document is subject to investigation and authorize FINA to make any inquiry of any person, firm or agency relevant to this document, and further authorize any person, firm or agency to provide information as may be requested by FINA. The National Federation hereby authorises to release further information concerning the change of sport nationality.