GENERAL FORM OF 2257A CERTIFICATION

[date]

Hon. William Barr Attorney General

U.S. Department of Justice
950 Pennsylvania Avenue, N.W.
Washington, DC 20530-0001

Re: Certification of [insert company name]

Pursuant to 18 U.S.C. § 2257A and 28 C.F.R. § 75.9

To the Honorable William Barr:

On behalf of [insert company name] [and {list sub-entities} or {its owned entities listed
in the attached Appendix}] (collectively, “[short form company name]”), I hereby certify
pursuant to 18 U.S.C. § 2257A(h)(1)(A) and 28 C.F.R. § 75.9 that all visual media [company]
produces are intended for commercial distribution, are created as part of a commercial enterprise,
and are not produced, marketed or made available in circumstances such that an ordinary person
would conclude they constitute “child pornography” as defined in 18 U.S.C. § 2256(8).

In support whereof, I attest that [company] is [list facts demonstrating that the
company is a commercial enterprise producing works for commercial distribution]. I
hereby further certify that [company] [and all sub-entities listed in this letter] or [its/their]
designees, agents and/or employees regularly and in the normal course of business collect and
maintain individually identifiable information regarding all performers employed by [company],
pursuant to Federal and State tax, labor, and other laws, and/or labor agreements, [and/or
otherwise pursuant to {list/identify industry standards}].

I also certify that foreign producers of visual depictions produced by [company] either
collect and maintain records required by 18 U.S.C. §§ 2257 and 2257A or have certified to your
office that they collect and maintain individually identifiable information regarding all perfor-
mers, including minor performers employed by that person, pursuant to tax, labor, and other
laws, labor agreements, or otherwise pursuant to industry standards, where such information
includes the name, address, and date of birth of the performer, in accordance with 28 C.F.R. Part
75, and that [company] has copies of those records or certifications. I further certify with respect
to foreign producers of visual depictions produced by [company] that do not maintain such
records and/or have not certified to your office, that [company] has taken reasonable steps to
confirm that the performers in any depictions that may potentially constitute simulated sexually
explicit conduct or lascivious exhibition of the genitals or pubic area of any person were not
minors at the time the depictions originally were produced.

Sincerely,

[name of CEO, other officer, or senior manager

responsible for activities that are subject of letter]

[{Chief Executive Officer} or {office/title}]