This Reprint Permission is for use by an individual or company when giving permission to reprint text, illustrations or photographs on a non-exclusive one time basis. This letter sets out the details of the request including the name and address of the individual to whom permission is given, the specific materials to be reprinted, where these materials are located and the credit line and/or copyright notice which must accompany the reprinted material. It is essential that this permission to reprint be set forth in writing. A written Reprint Permission will prove valuable if there are disagreements or misunderstandings regarding the one time reprint of the materials.

This Reprint Permission includes the following:

• Permission: Sets out the name and address of the individual to whom permission is given to reprint the specific materials;
• Material: Sets out the specific material to be reprinted (text, illustrations, photographs) and the location where this material is found (lines, page number, total number of words);
• Notices: Sets out the exact reading of any credit line or copyright notice which will accompany the material.

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This attorney-prepared packet contains:

1. Reprint Permission

State Law Compliance: This form complies with the laws of all states