That just comes down to the ESRB policy to include some justification for each content descriptor on the rating. One of the 5 things included in this case was "strong language", thus they need to include a reason why they gave strong language as a content descriptor.
The Japanese company (Minori) did not make the localization company (MangaGamer)get an ESRB rating when MangaGamer did a worldwide digital download release last year (and they aren't making MangaGamer get an ESRB rating for another upcoming title which is getting just a digital release)...
It's an 18+ visual novel that got adapted into 2 non-18+ TV anime series a few years back. See http://myanimelist.net/anime/2924/ef:_A_Tale_of_Memories has a brief overview of the first season of the all ages anime.
Apparently the Japanese company requested for them to get an official rating...
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