Explanation and Guide Form: Request for Permission to Use Copyrighted Material
Purpose:
This is a sample letter requesting the right to use copyrighted material from a copyright holder. The text in red and sections underlined in red indicate terms that will be unique to the particular circumstance (e.g. names of companies).
Form D03501
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[date]
[name and address of copyright owner]
Re:
Permission to Use Copyrighted Material
Dear [Name of Copyright Owner]: We are contacting you because you are the author of [copyrighted work] and we would like to [reprint or use] the [article, work, etc.]. We are in the business of __________________________. We plan to limit our use of your material to _________________. We will not use it in any other way. We respectfully request your support as the copyright holder to allow us the right to use the [article, work, etc.] free of charge in the manner described herein. If this is acceptable, you can simply sign and return to us a copy of this letter. Thank you for your consideration and your time. Sincerely,
[Name] By: ____________________________ Title: ___________________________
Permission is Hereby Granted Pursuant To the Terms and Conditions of this Letter
[Copyright Owner] By: ____________________________ Title: ___________________________
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