Permission to Reproduce Images by LegalZoom

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									PERMISSION TO REPRODUCE IMAGE(S) Date: __________________________ _____________________ (the “Owner”) has received the request of ____________________ (the “Requestor”), in a letter dated _____________________, _____, to reproduce the Image(s) (as defined below). The Owner hereby grants the request on the following terms and conditions, which terms and conditions Requestor hereby accepts: (1) The images described below (the “Image(s)”) are the subject of this agreement (the “Agreement”): Artist: Title: Date: Medium: Dimensions: The Owner is the copyright holder of the Image(s). (2) [The Requestor has already obtained a reproducible copy of the Image(s)] or [The Owner shall provide a [color print][black and white print][color transparency][35 mm slide][electronic version] of the Image(s) from which the Requestor can produce the Image(s) for the purposes described below.] (3) The Image(s) will be used as follows: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ _______________________________________________________________. (4) The Image(s) [will not be used in a seminar or other educational activity] [will be used in a seminar or other educational activity as follows: __________________________________________________________________ __________________________________________________________________ _______________________________________________________________.] (5) In consideration for the grant of the Owner’s permission to reproduce the Image(s), the Requestor agrees to pay a one time fee of $__________________ (the “Fee”). The permissions granted under this Agreement shall be ineffective until the Fee is paid in full. (6) This Agreement provides non-exclusive [worldwide] English 
								
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