TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
REGISTRAR'S NOTICE:
Forms used in administering the following regulation have been filed by the
Department of Professional and Occupational Regulation. The forms are not being
published; however, online users of this issue of the Virginia Register of
Regulations may click on the name of a form to access it. The forms are also
available from the agency contact or may be viewed at the Office of the
Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond,
Virginia 23219.
Title of Regulation: 18VAC120-40. Virginia
Professional Boxing and Wrestling Events Regulations.
Contact Information: Kate Nosbisch, Executive Director,
Department of Professional and Occupational Regulation, 9960 Mayland Drive,
Suite 400, Richmond, VA 23233, telephone (804) 367-8514, or email kate.nosbisch@dpor.virginia.gov.
FORMS (18VAC120-40)
Wrestling License Application, A511-4101LIC-v2 (eff.
1/2015)
Boxing License Application, A511-4102LIC-v2 (eff. 1/2015)
Boxing Manager/Matchmaker License Application,
A511-4103_04LIC (eff. 9/2012)
Trainer, Second or Cut Man License Application,
A511-4105LIC-v2 (eff. 1/2015)
Wrestling Promoter License Application, A511-4106LIC-v2
(eff. 9/2013)
Wrestling Event License Application, A511-4107LIC-v2 (eff.
1/2014)
Boxing Event License Application, A511-4108LIC-v2 (eff.
1/2014)
Boxing Promoter License Application, A511-4110LIC-v1 (eff.
9/2012)
Limited (Temporary) Wrestling License Application,
A511-4121LIC-v2 (eff. 1/2015)
Limited (Temporary) Boxing License Application,
A511-4122LIC-v2 (eff. 1/2015)
Martial Arts License Application, A511-4123LIC-v4 (rev.
8/2016)
Martial Arts License Application - Onsite, A511-4123LIC-v5
(rev. 8/2016)
Amateur Martial Arts - Sanctioning Organization Approval
Application, A511-4130AMA_SOA-v3 (rev. 7/2016)
Amateur Sanctioning Organization - Experience Verification
Form, A511-4130EXP-v2 (rev. 7/2016)
Event Cash Bond Form, A511-41ECBOND (eff. 9/2012)
Event Surety Bond Form, A511-41EVBOND (eff. 9/2012)
Event Card Additions and/or Deletions Form, A511-41EVCHG
(eff. 9/2012)
Promoter Payout Report, A511-41PAYREP (eff. 9/2012)
Promoter's Fee Report, A511-41PFR (eff. 9/2012)
Gate Fee Report, A511-41GFR-v2 (eff. 10/2015)
Criminal Conviction Reporting Form, A406-01CCR-v1 (eff.
5/2015)
Boxing Forms
Boxer/Limited
Boxer License Application, A511-4102_22LIC-v1 (eff. 9/2016)
Boxing/Martial
Arts Event License Application and Proposed Boxing/Martial Arts Bout Card,
A511-4108LIC-v4 (eff. 12/2016)
Additions/Substitutions/Deletions
to Proposed Boxing/Martial Arts Bout Card, A511-4108AD_BMA-v1 (eff. 12/2016)
Martial Arts Forms
Martial
Artist/Limited Martial Artist License Application, A511-4122_23LIC-v1 (eff.
9/2016)
Boxing/Martial
Arts Event License Application and Proposed Boxing/Martial Arts Bout Card,
A511-4108LIC-v4 (eff. 12/2016)
Additions/Substitutions/Deletions
to Proposed Boxing/Martial Arts Bout Card, A511-4108AD_BMA-v1 (eff. 12/2016)
Wrestling Forms
Wrestler/Limited
Wrestler License Application, A511-4101_21LIC-v1 (eff. 9/2016)
Wrestling
Event License Application and Proposed Wrestling Bout Card, A511-4107LIC-v4
(eff. 12/2016)
Additions/Substitutions/Deletions
to Proposed Wrestling Bout Card, A511-4107ADBC-v1 (eff. 12/2016)
General Forms
Manager
License Application, A511-4103LIC-v1 (eff. 9/2016)
Matchmaker
License Application, A511-4104LIC-v1 (eff. 9/2016)
Promoter
License Application, A511-4106_10LIC-v1 (eff. 9/2016)
Trainer,
Second or Cut Man License Application, A511-4105LIC-v5 (eff. 9/2016)
Amateur
Martial Arts - Sanctioning Organization Approval Application,
A511-4130AMA_SOA-v3 (eff. 7/2016)
Amateur
Sanctioning Organization - Experience Verification Form, A511-4130EXP-v2 (eff.
7/2016)
Event
Cash Bond Form, A511-41ECBOND-v2 (eff. 12/2015)
Event
Surety Bond Form, A511-41EVBOND-v2 (eff. 12/2015)
Gate
Fee Report, A511-41GFR-v3 (eff. 7/2016)
Promoter
Payout Report, A511-41PAYPREP-v2 (eff. 12/2015)
Criminal
Conviction Report Form, A406-01CCR-v2 (eff. 9/2015)
Disciplinary
Action Reporting Form, A406-01DAR-v1 (eff. 5/2015)
Denial
of Licensure Reporting Form, A406-01DEN-v1 (eff. 5/2015)
VA.R. Doc. No. R17-5027; Filed March 10, 2017, 1:05 p.m.