Sample Letter Requesting Permission to Reproduce ...



Template: Request Permission to Reproduce Copyrighted MaterialOn behalf of the Regents of the University of California, I ___(Fill in name)____ am requesting your permission to (check all that apply):_____reprint_____photocopy_____digitize_____incorporate into:_____course materials_____online course materials_____a website publication_____ a streaming online video (through YouTube or another source)the following material:Author:Title:Vol:Issue:Page #(s):Figure/Table #(s):Image #(s:)Minutes:The material will be distributed/published as follows:Purpose: Not-for-profit, educational [fill in if other]Format:Number of Copies:Distribution/Access:PERMISSION GRANTED: I, _________________________, have the authority to grant the permission requested herein and I hereby grant _____________________ permission to use the above referenced material in the manner described.The credit line should read:____________________________________________________________________________________________________________________________________________________________By: ________________________________Title:_______________________________Address:_____________________________________________________________________________________________________Date ................
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