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Sample Permission Request Letter

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Sample Permission Request Letter – Chapter Authors

To: Copyright Permission Department


______________________________
______________________________
______________________________ Date: _________

Copyright Permission Request

In my chapter tentatively entitled: ________________________________________________

that is to appear in the book: ____________________________________________________


edited by: ____________________________________________________________________

to be first published by Springer, I would greatly appreciate your permission to incorporate the
material set forth below with world rights in all languages, in this and any future editions,
revisions, adaptations or translations, and in any other form including, without limitation,
mechanical & electronic storage on any carrier:

Title: ________________________________________________________________________
Author(s): ____________________________________________________________________
Year of publication: ____________________________________________________________
Material for which permission is requested:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Please provide preferred line for copyright notice/credit:


_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Two copies of this request are enclosed. Please return one and retain one for your records.

Signed:________________________________

Name:_________________________________

Address:
______________________________________
______________________________________
______________________________________
______________________________________

**SPRINGER IS A SIGNATORY OF THE STM GUIDELINES AGREEMENT**


………………………………………………………………………………………………
We hereby grant permission for use of the material as specified above.

By:_________________________________

Title:_______________________________
http://www.springer.com/series/2506

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