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Form Letter for Copyright Permission

Sample for letter requesting permission to copy for class purposes.

You may also download a version of this sample letter in MS Word.

Date

Publisher's address

This is to request permission to photocopy, for class purposes, material to which we believe you hold or administer the copyright:

Author and title:

Specific pages to be photocopied:

Number of copies to be made:

Semester(s)/term(s) and year(s) of use:

The material will be identified on the first page of each copy by author and title of the book or article; the name of the series or journal and its editor, if applicable; the name of the publisher; and the complete copyright notice as it appears in your publication.

For your convenience, a permission form is appended below and a copy of this request is included for your files. If you are not the copyright holder, we will appreciate your giving us the name and address of the person to whom this request should be addressed.

Sincerely yours,


Typed name
Department and rank



Permission to photocopy is granted, as requested above


_________________________________________
Publisher


_________________________________________
Authorized officer

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Last updated February 12, 2008 | Created by Library Web Committee
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Brookens Library, University of Illinois at Springfield, One University Plaza, MS BRK 140, Springfield, Illinois 62703-5407
Brookens Library is a Federal Government Documents                           Depository.


February 12, 2008February 12, 2008