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                                                     PRINT , SIGN AND MAIL IN THIS FORM WITH I.D AND PAYMENT

DECLARATION (This is a legal document. Read it carefully!)

I hereby swear or affirm, under penalty of perjury, that:
I am currently an adult, at least 18 years of age;
I am voluntarily purchasing these materials because I want to view such materials for my own personal enjoyment and/or education;
I believe that a desire to view sexually explicit materials for enjoyment and/or education is a natural, healthy, and normal part of human behavior;
I understand that the materials I am seeking to acquire are sexually explicit, I am not offended by such materials, it is legal for persons of my age to purchase sexually explicit materials, such as those I seek to purchase, in my community and I will not order, or in any way acquire, materials or goods that would be unlawful to view or possess in my community;
I am familiar with the standards of my community pertaining to the distribution and/or viewing of such materials and the materials I am ordering will not offend the contemporary standards in my community and will not be found by an average member of my community to appeal to a prurient (unhealthy) interest in sex and/or to be patently offensive;
I will not show or distribute the materials to any individual who has not reached the lawful age to view such materials, or who might be offended by such materials;
I am not ordering these materials to use them against any interests of any person or entity; I will indemnify and hold harmless the provider of these materials from any and all civil claims or criminal charges that result from my ordering and/or distributing, in any manner, the materials.

You must complete the blank sections below and sign this form before we can process your order.
I declare under penalty of perjury under the laws of the State of ________________ (your state) and the United States that the foregoing is true and correct, and that this declaration was executed on this date, _________________ (today's date), in the city and state of ___________________ (your city and state).

SIGNATURE: ____________________________________x

PRINT YOUR NAME HERE: _________________________x