Certification form for video store records under grand jury subpoena, 2007

EFTA00186968¶

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA¶

IN RE FEDERAL GRAND JURY SUBPOENA OLY-66 ADDRESSED TO GUYS AND DOLLS VIDEO¶

CERTIFICATION REGARDING DOMESTIC RECORDS OF REGULARLY CONDUCTED ACTIVITY¶

I, the undersigned,___, declare that I am employed by Guys and Dolls Video, in the position of ___, and, by reason of my position, am authorized and qualified to make this declaration.¶

1. Through my employment with Guys and Dolls Video, I am familiar with the business records it maintains.

2. I certify that the records attached to this certification:

(a) were made at or near the time of the occurrence of the matters set forth therein, by or from information transmitted by, a person with knowledge of those matters;¶

(b) were kept in the course of regularly conducted business activity; and¶

(c) were made by the regularly conducted activity as a regular practice.¶

2. Among the records so maintained are the attached records itemized in Appendix A (Document Inventory).

Page 1 of 2¶

EFTA00186969¶

3. I further certify that the documents attached hereto are responsive to the Grand Jury Subpoena served upon Guys and Dolls Video.

Pursuant to 28 U.S.C. § 1746, I declare under penalty of perjury that the foregoing information is true and correct.¶

Executed this ___ day of ___, 2007.¶

Place of execution: ___¶

Signature¶

Page 2 of 2¶