The Rider 

For the UCI WorldTeam The paying agent [signatory’s name] 

Rider’s agent 

(text modified on 1.07.09; 1.07.10; 1.04.11; 1.07.12; 1.01.15; 1.01.18; 1.07.19). 

2.15.140 The parties declare that, apart from the present contract, 

## Declaration as per article 2.15.117 

no other contract has been concluded concerning the services of the contracting person for the benefit of the UCI WorldTeam in the sense of article 2.15.117 of the UCI cycling regulations. 

Done at ..... on ..... In 3 original copies 

The contracting person 

For the UCI WorldTeam The paying agent [signatory’s name] 

Rider’s agent 

 only the contracts below have been concluded in connection with the services of the contracting person for the benefit of the UCI WorldTeam: 

1. Contract Title 

2. Contract Title 

3. ... 

Done at ..... on ..... In 3 original copies 

The contracting person 

(text modified on 1.06.06; 1.04.11; 1.01.15). 

Parties: 

1. ... 

2. ... 

Date of signature: Contract in force from ... to ... Total pay and other benefits: 

Parties: 

1. ... 

2. ... 

Date of signature: Contract in force from ... to ... Total pay and other benefits: 

For the UCI WorldTeam The paying agent [signatory’s name] 

Rider’s agent 

