NATIONAL SECRETARIAT OF JUSTICE
DEPARTMENT OF JUSTICE, RATINGS, TITLES AND QUALIFICATION /
1. Platform: check more then one box only if the game content for all the checked platforms – including graphic detail, game style, interaction form, and interaction level – is the same. / GAME AND APP RATING FORM
- FILE ID TAG -
- DO NOT FILL -
- FOR OFFICIAL USE ONLY -
Computer (PC)
Computer (Mac)
PlayStation 2
PlayStation 3
PlayStation 4 / PlayStation Portable
PlayStation Vita
Nintendo DS
Nintendo 3DS
Wii / Wii U
Cell / Smartphone
Tablets
Smart TV
Xbox 360 / Xbox ONE
Android
iOS
Windows Phone
Other (replace)
2. Distribution Media: check all that apply for the game in the platforms checked on item 1. / 3. Category: check all that apply.
CD-ROM
DVD
Mini DVD
Blu-Ray / HD-DVD
UMD
Cartridge
Portable cartridge / Console built-in
Download
Internet*
Other (replace) / Action
Adventure
Cards or Cassino
Racing
Educational
Sports / Strategy
Trivia
Fighting
MMORPG
Platformer
Puzzle / Rhythm
RPG
Simulation
First Person Shooter
Third Person Shooter
Other (replace)
*It means the game will not be saved or installed in the player’s 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:3. Game publisher: / 4. Year of production: / 5. Country:
6. Game distributor in Brazil: / 7. Requested game rating (optional):
Livre 10 anos 12 anos 14 anos 16 anos 18 anos
8. Reason for the requested rating: check all that apply, if any / 9. Media sent to the Ministry with the content for rating:
Violence
Drug related content
Educational content / Sexual content
Language
Other (replace) / CD-ROM
DVD
Mini DVD
Blu-Ray / HD-DVD
UMD
Cartridge
Portable cartridge / Console built-in
Digital files / Pen-drive
Internet Link
Other (replace)
10. Violence: check all that apply
Blood / Blood-like Fluids
Cartoon Violence
Corpses
Cruelty
Disturbing/Depressing Themes / Killing
Language/Profanity
Mutilation
Pain or Suffering
Physical Aggression / Threats / Rape
Scary Scenes/Effects
Strong Impact Violence / Gore
Suicide
Torture / War-like Environment
Weapons
Wounds
11. Sexual content: check all that apply
Partial Nudity
Nudity / Erotic Language
Implied Sexual Relation / Sexual Relation
Explicit Sexual Relation / Prostitution
12. Drug related content: check all that apply
Use of Alcohol or Tobacco (NPC)
Use of Alcohol or Tobacco (Player) / Use of Illegal Drugs (NPC)
Use of Illegal Drugs (Player) / Drug Traffic
Drug Reference
5. Rating Requester
1. Name (person or company): / 2. CPF/CNPJ:3. Address: / 4. City:
/ 5. State: / 6. ZIP Code:
7. Email: / 8. Fax: / 9. Phone:
10. Person we may call in case of doubts or other issues:
11. Pertinent notes:
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 aforementioned contents.