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Photo or Article Copyright Permission Request Form Letter

To:_______________________________________Owner's Name
Email:____________________________________Owner's Email Address
I, _______________________________Your Name, request your permission to reprint the following items (described below) on my Web page:
_______________________________My URL.

I intend to use the copy(s) for the following:
__ Personal use
__ Research
__ Commercial use
__ Reporting __ Criticism or Review
__ Education
Item(s) to be Copied
Title______________________________________________Title of Article or Image____
URL:_____________________________________________URL of Article or Image____
Describe how the copies will be used:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Requestor Information
Name:_________________________________________Your Full Name
Company Name:_________________________________Your Company Name
URL:__________________________________________Your Web Page URL
Email Address:__________________________________Your Email Address
Phone Number:__________________________________Your Phone Number
Date:__________________________________________Today's Date