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Copyright Release For Publication

Complete the form fields below to generate a letter to ask a publisher's permission to reprint, quote from or otherwise distribute or publish copyrighted material. The request should be sent with a self-addressed return envelope to the permissions department of the publisher in question.

Click here for a sample of a letter written in the U.S. All information appearing in bold type are the form fields that are either automatically completed by the program or completed based on information you supplied in this form.

Your Name:
Publisher:
(Name of publisher/author from whom you want the copyrighted materials.)
Address:
City:
State/Province:
(Select a U.S. state or Canadian province.)
Zip/Postal Code:
Country:
I want permission to: reprint

photocopy

quote from

incorporate into a print publication
The following copyright material:
Author:
Volume:
(Only complete this if it's a journal or magazine)
Issue:
(Only complete this if it's a journal or magazine)
Page Numbers:
Images/Figures:
The material will be distributed/published as follows:
Distribution:
Publication:
Expected distribution/publication date:
Expected length of work:
(number of pages in your publication)
Target Market:

This is not a substitute for legal advice and it is suggested that an attorney be consulted.