The Librarian's Copyright Companion/Appendix I

by James S. Heller, Paul Hellyer, and Benjamin J. Keele

Appendix I

Sample Permission Letter
to Copyright Owner

[Date]

[Name and Address]

Dear __________:

I am writing to request permission to use [name of article/chapter from book/illustration …] for use in classes I teach at ______________ during the 2012/2013 academic year and in future semesters.

[If a Book]	[If an Article]
Title: Author:	Title: Author:
Chapter: Copyright Date:⁠ ISBN #	Volume Number and Pages:⁠ Copyright Date: ISSN #

The materials will be distributed to students enrolled in my classes, or made available through the library’s reserve operations or electronically. If the materials are placed on reserve, we will make no more than five copies. If the materials are made available electronically, they will be distributed only to students enrolled in the class on a secure website, and we will implement control procedures that restrict further distribution.

I greatly appreciate your supporting my students and their coursework. I hope you will agree to this non-profit academic use of your materials by returning this letter, with your signature, in the self-addressed envelope that I have enclosed for your convenience. Alternatively, you may e-mail your permission to me at [⁠ ].

Again, many thanks,

Name:
Title:
School Name/Address:
Phone Number/Fax Number/E-mail address:

Permission to Use the Materials Listed Above is Granted

Name:
Title:
Date: