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Ministry of Justice National Secretariat of Justice Game Rating Form Department of Justice, Ratings, Titles and Qualification

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Ministry of Justice National Secretariat of Justice Game Rating Form Department of Justice, Ratings, Titles and Qualification MINISTRY OF JUSTICE NATIONAL SECRETARIAT OF JUSTICE GAME RATING FORM DEPARTMENT OF JUSTICE, RATINGS, TITLES AND QUALIFICATION 1. Platform: check more then one box if, and only if, the game content for all the checked boxes – including graphic detail, game style, interaction form, and interaction level – is the very same. - FILE ID TAG - Computer (PC) PlayStation Portable Nintendo DS Computer (Mac) PlayStation Vita Nintendo DSi Xbox - DO NOT FILL - PlayStation One Game Cube Nintendo 3DS Xbox 360 - FOR OFFICIAL USE ONLY - PlayStation 2 Wii iPod / iPhone Web PlayStation 3 Wii U Cell / Smartphones 2. Distribution Media: check all that apply for the 3. Category: check all that apply. game in the platforms checked on item 1. CD-ROM HD-DVD Console built-in Action Strategy Rhythm DVD UMD Download Adventure Trivia RPG Mini DVD Cartridge Internet* Cards or Cassino Fighting Simulation Blu-Ray Portable cartridge Firefox Marketplace Racing MMORPG First Person Shooter Educational Platformer Third Person Shooter *It means the game will not be saved or installed in the player’s Sports Puzzle Other (replace) device, being accessed only in the online environment of a browser. 4. Title identification and content 1. Game Title in Brazil (just as it should be displayed): 2. Game original title: ROTOGAMEsq ROTOGAMEsq 3. Game publisher: 4. Year of production: 5. Country: Felix E. Klee, HIDDEN, Germany 2012 Germany 6. Game distributor in Brazil: 7. Requested game rating (optional): Firefox Marketplace operated by Mozilla Corporation, 650 Castro Street Suite 300, Livre 10 anos 12 anos 14 anos 16 anos 18 anos Mountain View, CA, 94041-2021, USA 8. Reason for the requested rating: check all that 9. Media sent to the Ministry with the content for rating: apply, if any CD-ROM HD-DVD Console built-in Violence Sexual content DVD UMD Digital files / Pen-drive Drug related content Language Mini DVD Cartridge Internet Link Educational content Other (replace) Blu-Ray Portable cartridge Other (replace) 10. Violence: check all that apply Blood / Blood-like Fluids Killing Rape Cartoon Violence Language/Profanity Scary Scenes/Effects War-like Environment Corpses Mutilation Strong Impact Violence / Gore Weapons Cruelty Pain or Suffering Suicide Wounds Disturbing/Depressing Themes Physical Aggression / Threats Torture 11. Sexual content: check all that apply Partial Nudity Erotic Language Sexual Relation Prostitution Nudity Implied Sexual Relation Explicit Sexual Relation 12. Drug related content: check all that apply Use of Alcohol or Tobacco (NPC) Use of Illegal Drugs (NPC) Drug Traffic Use of Alcohol or Tobacco (Player) Use of Illegal Drugs (Player) Drug Reference 5. Rating Requester 1. Name (person or company): 2. CPF/CNPJ: Felix E. Klee 3. Address: 4. City: 5. State: 6. ZIP Code: HIDDEN HIDDEN, Germany HIDDEN 7. Email: 8. Fax: 9. Phone: [email protected] +49.HIDDEN 10. Person we may call in case of doubts or other issues, if there is one in specific: 11. Pertinent notes: 12. Place and date: 13. Signature: HIDDEN, 28/11/2012 Send together with this form: game full synopsis, especially detailing contents regarding violence, sex and drugs; the game and/or a gameplay video of the game detailing the before mentioned contents. .
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