Request for Permission to Reprint Published Material by LegalZoom

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									      REQUEST FOR PERMISSION TO REPRINT PUBLISHED MATERIAL


                                                          [Your Street Address]
                                                          [City, State, and Zip Code]

                                                          [Insert Date]


Copyright Permissions Department
[Publisher’s Name]
[Publisher’s Company]
[Publisher’s Address]
[Publisher’s City, State, and Zip Code]


RE: Request for Permission to Reprint Published Material

Dear ___________________:

I am writing to request permission to reprint the Material (as defined below) from the
following publication:

Author:
Title:
Name of Publication:
Date of Original Publication:

I intend to use the following selection from the original published work:
________________________________________________________________________
________________________________________________________________________
_____________________________________________________________________
(the “Material”). The Material represents approximately _________ % of the original
published work. [I have enclosed copies of the Material with this letter for your
convenience.]

The Material will be used as follows, without deletions from, additions to, or changes in
the text thereof:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________
								
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