Reprint Permission Request

for Your State

This Reprint Permission Request is for use when requesting permission to reprint text, illustrations or photographs. This request sets out the specific materials to be reprinted, where they are found and any credit line or copyright notice which will accompany the reprints.

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This Reprint Permission Request is for use when requesting permission to reprint text, illustrations or photographs. This letter sets out the details of the request including the specific materials to be reprinted, where these materials are found and the credit line and copyright notice which will accompany the material. It is imperative that this request be memorialized in writing. A written Reprint Permission Request will prove invaluable in the event there are disagreements or misunderstandings regarding the reprinted materials.

This Reprint Permission Request includes the following:
  • Permission: Requests permission for non-exclusive rights to reprint the material;
  • Material: Sets out the specific material to be reprinted (text, illustrations, photographs) and the exact location where this material is found (lines, page number, total number of words);
  • Notices: Sets out the credit line and copyright notice which will accompany the material (such as “used by permission of” or “copyright”).

Protect your rights and your property by using our attorney-prepared forms.

This attorney-prepared packet contains:
  1. Reprint Permission Request
State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.





Request for Reprint Permission







This Packet Includes:
1. Information
2. Request for Reprint Permission
 





Information
Request for Reprint Permission




This form is for use in requesting the right to reprint text or photographs from another source, generally the publisher of the text or illustration.

To complete this form, include the date, the title of the publication in which the material appears, and the author or creator of the material. For text, include the page and line numbers of the material, the first and last words to be reprinted and a total word count. For illustrations or photos, list the page numbers and a description and total number of the illustrations to be reprinted. Also include the manner of the reprinting desired. Finally, you must include the name of the copyright owner and the date of the copyright for use on the credit line and copyright notice in the reprint.







DISCLAIMER:

FindLegalForms, Inc. (“FLF”) is not a law firm and does not provide legal advice. The use of these materials is not a substitute for legal advice. Only an attorney can provide legal advice.  An attorney should be consulted for all serious legal matters.  No Attorney-Client relationship is created by use of these materials.  

THESE MATERIALS ARE PROVIDED “AS-IS.  FLF DOES NOT GIVE ANY EXPRESS OR IMPLIED WARRANTIES OF MERCHANTABILITY, SUITABILITY OR COMPLETENESS FOR ANY OF THE MATERIALS FOR YOUR PARTICULAR NEEDS.  THE MATERIALS ARE USED AT YOUR OWN RISK.  IN NO EVENT WILL:  I) FLF, ITS AGENTS, PARTNERS, OR AFFILIATES; OR II) THE PROVIDERS, AUTHORS OR PUBLISHERS OF ITS MATERIALS, BE RESPONSIBLE OR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATE OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER USED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THESE MATERIALS.


 
REQUEST FOR REPRINT PERMISSION


Date: _________________________

To:


We request permission for the non-exclusive right to reprint the following material: ____________
________________________________________________________________________________________________________________________________________________________________

From: _______________________
By: _________________________

Textual Material: From Page _________________________, Line _________________________, through Page _________________________, Line _________________________, beginning with the words" _________________________ " and ending with the words " __________________ ," , and consisting of a total of _________________________ words.

Illustrations: On page(s) _________________________ and page(s) ________________________; described as:


and consisting of _________________________ illustrations/photographs.

We intend to reprint the material in the following manner:


The following credit line and copyright notice will accompany the use of this material:

"Used by permission of _________________________, Copyright ________________________ "



Thank you very much.

____________________________
Signature
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28167
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.





Request for Reprint Permission







This Packet Includes:
1. Information
2. Request for Reprint Permission
 





Information
Request for Reprint Permission




This form is for use in requesting the right to reprint text or photographs from another source, generally the publisher of the text or illustration.

To complete this form, include the date, the title of the publication in which the material appears, and the author or creator of the material. For text, include the page and line numbers of the material, the first and last words to be reprinted and a total word count. For illustrations or photos, list the page numbers and a description and total number of the illustrations to be reprinted. Also include the manner of the reprinting desired. Finally, you must include the name of the copyright owner and the date of the copyright for use on the credit line and copyright notice in the reprint.







DISCLAIMER:

FindLegalForms, Inc. (“FLF”) is not a law firm and does not provide legal advice. The use of these materials is not a substitute for legal advice. Only an attorney can provide legal advice.  An attorney should be consulted for all serious legal matters.  No Attorney-Client relationship is created by use of these materials.  

THESE MATERIALS ARE PROVIDED “AS-IS.  FLF DOES NOT GIVE ANY EXPRESS OR IMPLIED WARRANTIES OF MERCHANTABILITY, SUITABILITY OR COMPLETENESS FOR ANY OF THE MATERIALS FOR YOUR PARTICULAR NEEDS.  THE MATERIALS ARE USED AT YOUR OWN RISK.  IN NO EVENT WILL:  I) FLF, ITS AGENTS, PARTNERS, OR AFFILIATES; OR II) THE PROVIDERS, AUTHORS OR PUBLISHERS OF ITS MATERIALS, BE RESPONSIBLE OR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATE OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER USED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THESE MATERIALS.


 
REQUEST FOR REPRINT PERMISSION


Date: _________________________

To:


We request permission for the non-exclusive right to reprint the following material: ____________
________________________________________________________________________________________________________________________________________________________________

From: _______________________
By: _________________________

Textual Material: From Page _________________________, Line _________________________, through Page _________________________, Line _________________________, beginning with the words" _________________________ " and ending with the words " __________________ ," , and consisting of a total of _________________________ words.

Illustrations: On page(s) _________________________ and page(s) ________________________; described as:


and consisting of _________________________ illustrations/photographs.

We intend to reprint the material in the following manner:


The following credit line and copyright notice will accompany the use of this material:

"Used by permission of _________________________, Copyright ________________________ "



Thank you very much.

____________________________
Signature
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