DocuSign Envelope ID: B4F656ED-6260-4C4C-827B-F0EAD0A5EC92

Contributor information
Unlogic Idn
Name

Joresan Mlarak Rt/Rw 02/02 dukuh Joresan 02

Address

SHUTTERSTOCK, INC. Ponorogo Jawa Timur

City State
Model Release for ADULT
Indonesia 63472
For good and valuable consideration, the receipt and legal sufficiency of which Country Postal code
is hereby acknowledged, I (the “Model” signing) hereby grant to the Contributor azhalahmad10@gmail.com
and SHUTTERSTOCK, INC. (collectively, the “Contributor”), the Contributor’s Email Phone
assigns, and those persons acting with the Contributor’s authority and +6282229334418
permission, the right to take and create photographs/videos and other still
and/or moving images (in all formats) and other graphical depictions Signature Date 12/8/2021
incorporating my likeness, in any and all media, whether now known or
hereafter created (the “Content”). Women model she is my wife
Notes
I hereby agree that all rights in and to the Content, including the copyright, are (optional)
and shall remain the sole property of the Contributor, free and clear from any
claims by me or anyone acting on my behalf.
I understand and agree that the Contributor’s and the Contributor’s assigns’
rights include, but are not limited to, the rights, in perpetuity, to:
Model information
• Use, re-use, publish, and re-publish the Content;
zulviana vinda dwi nur evi sulaekah
• Alter, modify or otherwise change the Content in any manner the
Contributor desires or permits;
Name

sadon lor, sriti, sawoo

• Index and analyze the Content, which may involve extracting scans of my
image, likeness, facial geometry and other biometric data as may be
Address

ponorogo jawa timur

derived from the Content; City State

• Combine the Content with textual matter and/or with other pictures
and/or media; and, Country
indonesia
Postal code
63475
zulviananur10@gmail.com
• Use the Content for illustration, promotion, art, editorial, advertising,
trade, publishing, or any other purpose whatsoever. Email Phone
+6282264077977
I acknowledge and agree that I have no further right to additional consideration Signature Date 12/8/2021
or accounting from any sublicensing, distribution, publication, and/or further
uses of the Content and that this license and release allows the use of my
image, likeness, and derivatives thereof in the Content worldwide in perpetuity. Date of birth 09/23/2000
I hereby release, discharge, and agree to hold harmless the Contributor, the
Notes i like to be honest
Contributor’s heirs, legal representatives and assigns, and all persons acting
under the Contributor’s authority or those for whom he/she is acting, from any (optional)
liability by virtue of any use of the Content or any changes or alterations made
thereto, including from claims for defamation or invasion of privacy or
publicity. I acknowledge that the Contributor is not responsible or liable for any Information you provide about your gender and ethnicity will help us
unauthorized use or piracy of the Content. enable customers to find the content they’re looking for.

I agree and understand that my personal information provided in this release

will not be made publicly available but may only be used directly in relation to Model’s racial or ethnic identification
the licensing of the Content where necessary (e.g. to defend claims, protect Optional — Select up to two
rights or notify trade unions) and may be retained as long as necessary to fulfill
African African American Black
this purpose, including by being shared with sub-licensees and assigns of the
Contributor and transferred to countries with differing data protection and Brazilian Chinese Caucasian (white)
privacy laws where it may be stored, accessed and used.
East Asian Hispanic / Latin Japanese
I hereby warrant that I am of full legal age and have the right to contract in my
own name. I have read the above authorization, release and agreement, prior to Middle Eastern Native American Pacific Islander
its execution, and I am fully familiar with the contents thereof. I agree that this
release shall be binding upon me and my heirs, legal representatives and South Asian X Southeast Asian
assigns. I agree that this release is valid and enforceable in the jurisdiction in
which I reside, and I agree to enter into this release in the English language and
hereby waive any and all claims of invalidity related to the form and terms of Model’s gender identification
this release. Optional
X Female-identified Male-identified Non-binary

Other:

Visual reference
Optional headshot or other reference maybe attached here.
For images or videos that contain nudity orsexually suggestive
themes, a government issued identification document showing
date of birth is required.
350 5th Avenue 21st Floor New York New York 10118
866.663.3954 www.shutterstock.com
Adult model release
DocuSign Envelope ID: B4F656ED-6260-4C4C-827B-F0EAD0A5EC92