[Your Full Name or Company Name]
[Your Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]
Date: [Date]
To: [Copyright Owner’s Full Name or Company Name]
[Recipient Address]
[City, State, ZIP Code]
Subject: Request for Permission to Use Copyrighted Material
Dear [Copyright Owner Name],
1. Purpose of This Letter
I am writing to request your permission to use copyrighted material that I understand is owned or controlled by you.
I would like to obtain your written authorization before using the material described below.
2. Description of Copyrighted Material
The copyrighted material I would like permission to use is as follows:
-
Title or Description of Work: [Title or Description]
-
Author / Creator: [Name]
-
Publication, Website, or Source: [Source]
-
Date of Publication, if known: [Date]
-
Specific Portion Requested: [Page numbers, excerpt, image, clip, chart, song portion, or other description]
Title or Description of Work: [Title or Description]
Author / Creator: [Name]
Publication, Website, or Source: [Source]
Date of Publication, if known: [Date]
Specific Portion Requested: [Page numbers, excerpt, image, clip, chart, song portion, or other description]
3. Proposed Use
I would like to use the material for the following purpose:
[Describe how the material will be used]
Additional details of the proposed use are as follows:
-
Type of Use: [Print / Website / Social Media / Video / Presentation / Educational Material / Advertising / Other]
-
Commercial or Non-Commercial Use: [Commercial / Non-Commercial]
-
Distribution Area: [Local / National / Worldwide / Online]
-
Expected Audience or Circulation: [Describe]
-
Planned Date of Use or Publication: [Date]
-
Duration of Requested Permission: [One-time use / limited period / ongoing use / other]
Type of Use: [Print / Website / Social Media / Video / Presentation / Educational Material / Advertising / Other]
Commercial or Non-Commercial Use: [Commercial / Non-Commercial]
Distribution Area: [Local / National / Worldwide / Online]
Expected Audience or Circulation: [Describe]
Planned Date of Use or Publication: [Date]
Duration of Requested Permission: [One-time use / limited period / ongoing use / other]
4. Credit and Attribution
If you grant permission, I am willing to provide credit or attribution as follows:
[Describe proposed credit line]
If you require a specific credit format, please let me know and I will make reasonable efforts to use it as requested.
5. Fees or License Terms
Please let me know whether you require a licensing fee, royalty, or any other condition for granting permission.
If you already use a standard permission form or license agreement, please send it to me for review.
6. Request for Written Confirmation
If you agree to this request, please confirm in writing that I have permission to use the material as described above.
You may include any limitations, conditions, required wording, usage restrictions, expiration date, or other terms that should apply to the permission.
If you have any questions or need additional information, please contact me at:
Name: [Your Full Name]
Email: [Email Address]
Phone: [Phone Number]
Mailing Address: [Address]
Thank you for considering my request. I appreciate your time and attention.
8. Signatures
Sincerely,
Signature: __________________________
Name: [Your Full Name]
Title: [Title, if applicable]
Company: [Company Name, if applicable]
Date: [Date]