Professional Documents
Culture Documents
PerformerRelease PDF
PerformerRelease PDF
PerformerRelease PDF
by this document is required to comply with United States federal law and any false statement or misrepresentation is a crime under the
Age: 37
I have also used the following names, stage names, aliases, nicknames and married and /or maiden names:
(1) (2)
(3) (4)
If more than 4 please attach a separate sheet, signed by the performer, with all names.
X Check this box to attest you have read and agree with the Terms of Use of Cam4 and you
acknowledge you have licensed your images to Cam4 and that you will keep all documents and information required
to be kept by 18 U.S.C. §2257 and 18 U.S.C. §2257A and associated regulations, 28 CFR 75 et seq., in the manner required by law,
I, iaca testu (full legal name) pursuant to 28 U.S.C. $1746 and the penalties of
perjury, under the laws of the United States, swear that the above is true and correct and that the ID
which I have provided, a copy of which is attached and signed by me, was lawfully obtained by me