18 U.S.C § 2257 Records Keeping for Models
A. I,  (print full legal name) ("Model"), understand that all the information required by this document is required to comply with United States federal law and any false statement or misrepresentation is a crime under United States law.
B. Two forms of identification, including at least one government issued photo ID, are required. Describe each, including number. Clear photocopies of each must be attached and the photocopies must be signed in BLUE ink by the artist.
ID 1 (type):
ID 1 (number):
 
ID 2 (type):
ID 2 (number)


 


Birthdate:
Month 
Day Year 
Age: 
SNN: 
Is model a US citizen or does Model have a US "green card"? YES (based on your IP address) 
If "yes", US issued identification MUST be used. 
C. 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 model including the addicional names.
MODEL'S SWORN STATEMENT: I, (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 and has not been forged or altered.
Today's Date: 
Signature:
__________________________________
 
Model's Signature (using full legal name)
PRODUCER'S / PHOTOGRAPHER'S SWORD STATEMENT: Pursuant to 28 U.S.C. § 1746 and the penalties of perjury under the laws of the United States, I swear that I have personally examined the Model’s ID containing the date of birth set forth above, that I have personally questioned the Model regarding the answers given in this document, and that I have observed that Model execute this document and sign the attached copy of the ID. In addition, I swear that the date set forth below is the date on which production involving this model occurred.
Date of Production: 
Location of Production: 
TITLE or ALPHA/NUMERIC description: 
 
 
 

 
_________________________
Print Name of Producer
 
Signature of Producer
NOTE: THIS DOCUMENT TO BE KEPT SEPARATE FROM ALL OTHER RECORDS