Katrina T. O'Brien 14460 NW Pioneer Park Way, Beaverton, OR 97006 971.226.1681 ktob@MyResearchNeeds.com

Image Reprint Permission Example Letter

Date

Name,

I am writing to request permission to reproduce the following image from Owner and to request a photographic print/color transparency copy in order to produce the image for my forthcoming book, Title to be published by Publisher, a (Description).

• Author(s) and/or editor(s): include
• Title of Image:  include Description
• Copyright Date: include
• Exact Material if included in another publication: include if appropriate

My book, which is tentatively scheduled for publication in Date, will be approximately Number pages and has an initial print run of Number copies. The image I wish to reprint will have either a half-page or quarter-page image. It may also be required for advertising purposes.

I am requesting non-exclusive worldwide rights, all languages, for this edition in cloth and paperback, and for any subsequent editions in the same format. This request covers all future revisions and editions of my book, and versions made by nonprofit organizations for blind or physically handicapped persons, published by Publisher or its licensees. Proper acknowledgment of title, author, and publisher will be given.

Add if appropriate: Publisher is a non-profit publisher and this book will be for an academic audience only.  I would appreciate it if you could waive or reduce any reproduction fees.

Please specify below any credit line you would require if permission is granted. In signing, you warrant that you/company are the sole owner of the rights granted and that your material does not infringe upon the copyright or other rights of anyone. If you do not control these rights in their entirety, we would appreciate your letting us know to whom we should apply.

Thank you for your assistance.

Sincerely,

Author

Contact Information

PERMISSION GRANTED as stated above:

____________________________                Credt Line:                                                    

Signature                                                                                                                                                                                                                     

____________________________

Printed name                                                    

____________________________

Title, Company

____________________________

Date