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I CERTIFY BY MY LEGAL SIGNATURE BELOW, UNDER PENALTY OF PERJURY, THAT THE FOLLOWING STATEMENTS ARE TRUE AND CORRECT REGARDING THE PURCHASE OR EXCHANGE OF SEXUALLY ORIENTED VIDEOS:
1. I am an adult, over 21 years of age.
2. I am freely entering into this purchase or exchange in the capacity of a private citizen, and am not in any way connected with, employed by, acting on the behalf of, or at the request or suggestion of any Federal, state or local law enforcement or information gathering agency, or of the United States Postal Inspection Service. The materials I am requesting will not be used against any person whomsoever, in any conceivable manner.
3. I have never requested that my name be put on any list complied by the United States Postal Service, or any government or private agency which would expressly forbid me from receiving sexually oriented materials through the mails, or through other channels.
4. I certify that the video tapes to be purchased or exchanged are for my sole and personal possession and use, and are for my educational, entertainment or amusement purpose only, and shall not be shown to minors or to other persons who might find the subject matter to be personally offensive.
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