Artist Identifying Information And Affidavit
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12014 BRIEFS EROTIC SHORTS FILM FESTIVAL
THIS IS A LEGALLY BINDING CONTRACT. READ IT CAREFULLY.
Film Name: _______________________________________________________________________________
ARTIST IDENTIFYING INFORMATION AND AFFIDAVIT
Artist understands that all the information given in this Agreement is being provided to comply with federal
law, and any false statement will subject Artist to both a civil action by Producer as well as criminal prosecution
under federal and state law. Please print legibly.
a.
Legal Name: _______ _________________________________
b. Date of birth _______________________
(Full current legal name: first, middle, last)
(Month, Day, and Year)
c.
Two forms of identification, including at least one government issued photo ID are required. Describe
each, including number. (Photocopies of each must be attached and the photocopies must be
signed in ink by Artist):
(1) First type of Identification:
ID#___________________________
(2) Second type of Identification:
ID#___________________________
d.
All other names ever used (include all stage names, maiden names and nicknames):
(1) ______ ________________________________
(4) ______ ______________________
(STAGE NAME FOR THIS PRODUCTION)
(ALL OTHER NAMES)
(2) ________________________________________
(5)______________________________
(MAIDEN NAME IF APPLICABLE)
(ALL OTHER NAMES)
(3) ____________________________________________
(6) ________________________________
(ALL OTHER NAMES)
(ALL OTHER NAMES)
e.
Social Security:__ ___________________________ f. Phone #: ___________________________
g.
Address: __________________________________________________________________________________
h. City State Zip______________________________________________________________________________
i.
E-mail address:_________________________________________________________________
UNDER THE PENALTY OF PERJURY OF THIS STATE, 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.
ARTIST MUST ALSO SIGN ATTACHED COPIES!
Today’s Date:_________________
Signature: ______________________________________
ARTIST’S SIGNATURE USING FULL LEGAL NAME
UNDER THE PENALTY OF PERJURY OF THIS STATE, I SWEAR THAT THE FOREGOING IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND BELIEF, AND THAT I HAVE OBSERVED THE ORIGINALS OF EACH OF THE IDENTIFICATION DOCUMENTS OF WHICH COPIES ARE ATTACTED HERETO
AND SIGNED BY THE ARTIST.
Today’s Date:_________________
Signature:_____________________________________________
(SIGNATURE OF PRIMARY PRODUCER, DIRECTOR & ID INSPECTOR
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