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I know what is compliance! and we provide our clients with Compliance 2257

RECORDS KEEPING COMPLIANCE FORM
PURSUANT TO 18 U.S.C. § 2257


MODEL IDENTIFYING INFORMATION AND AFFIDAVIT: Model understands that all the information given in this Agreement is being provided to comply with federal law and any false statement will subject Model to both a civil action by Producer as well as criminal prosecution under federal and state law. _____________
(Model?s Initials)
Please print legibly.

a. Legal Name: _________________________ b. Date of Birth: ____________
(Full Current Legal Name: First, Middle, Last) (Month, Day and Year)
Age: ___________ ___ ___________________

c. The aforementioned information was acquired by the mandatory examination of the following Two Forms of Identification, including at least one government-issued photo identification document such as a Valid Driver?s License or a Passport: (Each should be described, including the ID number. Clear, good-quality photocopies of each must be attached to this Form and the photocopies must be signed in ink by Model):

(1) First form of identification: (2) Second form of identification:

____________________________ ___________________________________

ID # ________________________ ID # _______________________________

Note: If ID does not contain a recent and recognizable picture of the Model, only a Drivers? License, State ID Card or Military ID will be acceptable for U.S. Models; and only a passport will be acceptable for foreign Models, in such circumstances. Unless both the Model and the producer are located outside the U.S., a ?picture identification card? as defined in CFR 75.2(a)(1) must be examined to ascertain the model?s legal name and date of birth prior to completing this form.

d. All other names ever used (include all stage names, Web handles, maiden names, aliases, professional names and nicknames):

(1) ____________________________ (a) _________________________________
(Stage Name for this Production) (All other names)

(2) ____________________________ (b) _________________________________
(Maiden Name if applicable) (All other names)

(3) ____________________________ (c) _________________________________
(Previous legal name, if applicable) (All other names)






SWORN STATEMENT: ?UNDER 28 U.S.C. §1746 AND THE PENALTIES OF PERJURY UNDER THE LAWS OF THE UNITED STATES, I SWEAR THAT THE FOREGOING IS TRUE AND CORRECT AND THAT EACH OF THE IDENTIFICATION DOCUMENTS WHICH I HAVE PROVIDED AND OF WHICH I HAVE SIGNED THE ATTACHED COPY WAS LAWFULLY OBTAINED BY ME AND HAS NOT BEEN FORGED OR ALTERED.?

Today?s Date:_________________


Signature: _______________________________________
Model?s Signature (using full legal name)


MODEL MUST ALSO SIGN ATTACHED ID COPIES!


UNDER 28 U.S.C. §1746 AND THE PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES, I SWEAR THAT THE FOREGOING IS TRUE AND CORRECT, THAT I HAVE PERSONALLY EXAMINED THE MODEL?S PHOTO IDENTIFICATION AND DATE OF BIRTH, THAT I HAVE PERSONALLY QUESTIONED THE MODEL REGARDING THE ANSWERS GIVEN IN THIS AGREEMENT, AND THAT I HAVE OBSERVED THE ORIGINALS OF EACH OF THE IDENTIFICATION DOCUMENTS OF WHICH COPIES ARE ATTACHED HERETO AND SIGNED BY THE MODEL. IN ADDITION, I SWEAR THAT THE DATE SET FORTH BELOW IS THE DATE ON WHICH PRODUCTION OCCURRED.

Today?s Date: _________________

_____________________________
Print Name of Producer

_____________________________
Signature of Primary Producer



MODEL RELEASE AND GRANT OF RIGHTS

As of the date written below, for the consideration set forth herein, Model and Producer, whose names are set forth below, hereby agree as follows:

1. SERVICES.

On behalf of Producer, Model will render services as an actor/performer for one or more Web sites and such other media outlets as the Producer shall designate. Model agrees to render such services on an exclusive basis at the dates, times and places set forth below (or as otherwise directed by Producer), and further until the completion of the principle photography of the Project. Model, a consenting adult, shall perform to the best of Model?s ability, and in a conscientious and artistic manner, all of the services required by the Producer with due regard for the efficient production of motion pictures or still photography. Such services may include without limitation, pre-production services, services in connection with principle photography of the Project, post-production services, including retakes, such other services as are customarily performed or required to be performed by an actor in a motion picture or magazine and to comply with all reasonable directions, requests and rules of Producer in connection herewith, whether or not the same involves matters of artistic taste or judgment.

Model?s Legal Name:_____________________________________________ _
(Full Current Legal Name: First, Middle, Last)
Date of Birth: ______________ Age: ___________
(Month, Day and Year)

Social Security No.: ___________________________ Phone:_______________

Address:____________________________ Email Address: _________________

Location of services:_________________________________________ ______

Description of services:_________________________________________ ____
__________________________________________________ _______________
__________________________________________________ _______________

Title of Photo Shoot/Video Production:________________________________

Date of Production(s):____________________________________ __________

Time(s):__________________________________________ ________________

Model,______________________________, solemnly declares under penalty of perjury that:

_____ I have read and thoroughly understand the terms and conditions of the Services I will offer.

_____ I agree to cooperate with the Producer to confirm the accuracy of any and all the information contained in this Agreement if and when I am contacted at the following telephone number:_____________________________________.

______The information and photo identification produced and attached to this Agreement is correct and valid.

______I am eighteen (18) years or older, and I have the capacity to enter into this Agreement.

______My performance of sexual activities is completely voluntary and I will be compensated by the Producer for the right to record and photograph my image(s).

______I am not under the influence of any intoxicating substance, including but not limited to alcohol or drugs, and I understand that these are not allowed on the premises during this project.

______I do not suffer from any mental or nervous condition that would affect my ability to knowingly and voluntarily enter into this agreement.

______I do not have any health condition or sexually transmitted diseases that would expose others to negative health conditions from engaging in sexual activities with me.

2. COMPENSATION.

a. Base Compensation:

For the services rendered and to be rendered under this Agreement, Producer agrees to pay Model the base compensation of $___________________________________.

b. Special Compensation: (Optional)

Special Compensation: $_________________________________
$_________________________________

________________ __________________
Producer?s initials Model?s initials

Producer agrees to pay Model the sum total of $________________________________ for performing specific scenes and acts as they may agree upon. Unless this paragraph is initialed and an amount specified, Model shall be entitled to no special compensation.


3. BINDING ARBITRATION.

a. Arbitral Claims. All disputes between Model and Producer (and their respective attorneys, successors and assigns) of any kind whatsoever, arising from the transaction reflected in this Agreement (?Arbitral Claims?) shall be resolved by arbitration. Arbitral Claims shall include, but are not limited to, contract and tort claims of all kinds, and all claims based on any federal, state or local law, statute, or regulation, excepting only claims under applicable worker?s compensation law and unemployment insurance claims. Arbitration shall be final and binding upon the parties and shall be the exclusive remedy for all Arbitral Claims. THE PARTIES HEREBY WAIVE ANY RIGHTS THEY MAY HAVE TO TRIAL BY JURY IN REGARD TO ARBITRAL CLAIMS.

b. Procedure. Arbitration of Arbitral Claims shall be in accordance with the Employment Dispute Resolution Rules of the American Arbitration Association (?AAA Employment Rules?). Attorneys? fees and the fees of the arbitrator shall be paid by the losing party, as identified by the arbitrator. Any arbitration hearing shall occur in Seminole County, Florida, unless otherwise ordered by the Arbitrator or agreed by the parties.





Any more questions?

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