SAMPLE PERMISSION REQUEST LETTER AND FORM

[Adapt this letter to send out under your own letterhead with the accompanying form. At the top of the form, fill in the description of the item for which you are seeking permission and, near the bottom, your proposed credit line. Send two copies of the letter and form to each recipient, together with a selfaddressed, stamped envelope.] Dear [name], I am the author [or editor] of the book [title], to be published by the University of British Columbia Press in [season and year]. I am writin to ask for your permission to reprodu!e an e"!erpt [or an illustration] in this publi!ation. #he sour!e information that I have for this e"!erpt [or illustration] is as follows$ [For a text, give the author, complete title, complete publication details for the journal or book in which the excerpt appeared, including page numbers. ite the first and last few phrases of the passage and indicate the total number of words.] [For a photograph, give the name of the photographer and a brief description of the subject of the photograph or !where applicable" the creator and title of the work shown in the photograph. For another type of illustration, such as a map or diagram, or for a table, give complete source information as for a text, along with a brief description and the name of the creator, if known. ] I am en!losin a photo!opy of the e"!erpt [or the illustration]. #he University of British Columbia Press is a nonprofit, a!ademi! publishin house. [ #ook title] is a s!holarly study, appro"imately [number] printed pa es in len th, whi!h will be published in an edition of [number] !opies. It will be sold to libraries, s!holars, and interested eneral readers. I am re%uestin permission to reprodu!e the e"!erpt [or the illustration] in all editions and formats related to this book, including electronic, for the duration of the publi!ation, and in print and online advertisin and marketin materials promotin the book. Please note that a !redit line will appear prominently in the book a!knowled in that the material is used with the permission of the !opyri ht holder. [$F A%%&$ A#&']$ I also re%uest permission to reprodu!e the illustration on the !over of the book and in materials advertisin and promotin the book. [$F A%%&$ A#&']$ I will re!eive no royalties on the first edition of the book.] I would be most rateful if you !ould waive any reprodu!tion fees& in return for this !ourtesy, I !an offer you one !omplimentary !opy of the book. Please !omplete one !opy of the en!losed form, si n it, and return it to me at your earliest !onvenien!e, to ether with one !opy of this letter. #he se!ond !opies of the form and the letter are for your re!ords. 'ou may fa" the !ompleted form and letter to me at [fa" number]. #hank you very mu!h for your help in this matter. If you have any %uestions, please !all me at [phone number] or email your %uery to [email address].

Des!ription of item$ [as specified on the first page of this letter]$ Please !omplete this pa e and return one !opy to me, to ether with the atta!hed letter. ( se!ond !opy is en!losed for your !onvenien!e. Please !he!k one$ I)we !laim no ri hts in this work. *+ I)we !laim full ri hts in this work. *+ I)we !laim only the followin ri hts in this work$ ,or other ri hts, please !onta!t -name.$ -address.$ Please !he!k one$ I)we waive any fee, in e"!han e for one !omplimentary !opy of the book. *+ #he fee for use in the book is / , payable on publi!ation of the book. #he fee for use on the !over is / , payable upon publi!ation. #he fee for use in advertisin and promotin the book is / , payable upon su!h use. Please !he!k one$ #he followin !redit line is a!!eptable [Applicant( insert proposed credit line here]$ *+ I)we prefer the followin !redit line$

,or a work of art, please spe!ify medium, dimension, date, and lo!ation$

I)we hereby rant permission for the use of this item as outlined in the a!!ompanyin letter. I)we warrant that I)we have the le al authority to rant the ri hts spe!ified. 0i nature$ Date$