FINANCE DIVISION
FUNDS & RESEARCH SECTION
Tel. 08-6461233 Fax. 08-6472885
To Date:
The Publisher
________
________
_ _ _ _ _ _ __
Dear Sir/ Madam,
Re.:
I the undersigned hereby request that you pay the sum of USD _ _ _ _ out
of the royalties for the above-mentioned book, to cover the participation
of Ben-Gurion University in publication costs.
Any amount transferred to Ben- Gurion University of the Negev may be
considered as paid to me.
Any tax (if there is any), subsequent to the royalties earned by me, would
be applied to me and paid only by me.
Yours sincerely,
Name of researcher Signature