The Copyright Permission Request Form Letter

To:            Anthony Buccino
Email:        Email Copyright Permission

I, ____(Your Name)_______________________________,

request your permission to reprint the following items (described below)

on my Web page: ________________________________________________

Your URL _______________________________________________________.

in Print: _________________________________________________________________

I intend to use the copy(s) for the following:

__ Personal use
__ Research
__ Commercial use
__ Reporting

__ Criticism or Review
__ Education

 

Item(s) to be Copied

title of Article or Image ___________________________

URL of Article or Image _____________________________
 

Describe how the copies will be used:
______________________________________
______________________________________

______________________________________

______________________________________

Requestor Information
Your Full Name ______________________________________
Your Company Name __________________________________
Your Web Page URL ___________________________________
Your Email Address ___________________________________
Your Phone Number __________________________________
Today's Date _________________________________________