Of nº 199 - D Árb
Ilmo Sr. Presidente da CONFEDERA??O BRASILEIRA DE FUTEBOL DE SAL?O - CBFSO atleta abaixo assinado:Insc. CBFS:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Data de Nascimento:RG: CPF: _________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________Filia??o:Pai:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Nome por extenso)M?e:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Nome por extenso)Responsável Legal:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Preenchimento obrigatório do nome por extenso, quando tratar-se de atleta menor)Residente:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Município:UF:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________End. Eletr?nico: (e-mail)___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Inscrito na Federa??o:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________VEM REQUERER A VOSSA SENHORIA QUE SE DIGNE A REGISTRAR A SUA TRANSFER?NCIA ENTRE CLUBES DA MESMA FEDERA??ODe:Para:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Nome Oficial do Clube de Origem)(Nome Oficial do Clube de Destino)TERMOS EM QUE PEDE E ESPERA DEFERIMENTOx_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Local e DataAssinatura do Atleta RequerenteAutorizo a presente solicita??o de TRANSFER?NCIA LOCAL:x________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Local e Data(Assinatura do pai, m?e ou responsável legal com firma reconhecida em cartório)Clube de Destino: Ciente:x_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Assinatura do Presidente do ClubeAssinatura do Presidente da Federa??oO atleta signatário declara, sob as penas da lei, que todas as informa??es e dados aqui consignados expressam a verdade. ................
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