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Request For Permission To Reuse Previously Published Material TO: Rights & Permissions Department

This document is a request for permission to reuse previously published material. It provides details of the original publication such as the full title, authors, publication date, and description of the specific material to be reused. It also provides details of the new publication where this material will be reused, and requests a reply with approval or any special instructions.

Uploaded by

Bustami Muhammad Sidik
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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188 views2 pages

Request For Permission To Reuse Previously Published Material TO: Rights & Permissions Department

This document is a request for permission to reuse previously published material. It provides details of the original publication such as the full title, authors, publication date, and description of the specific material to be reused. It also provides details of the new publication where this material will be reused, and requests a reply with approval or any special instructions.

Uploaded by

Bustami Muhammad Sidik
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REQUEST FOR PERMISSION TO REUSE PREVIOUSLY PUBLISHED MATERIAL

TO: Rights & Permissions Department


Publisher:
Address:

E-mail:
FAX:
Date:

Requestors Contact Information


First name:
Family name:
E-mail:
Address:

Phone:
FAX:
Date:

We seek permission to reuse material previously published in one of your publications. We intend to
include the material in a new manuscript being submitted for publication to another publisher. We
request nonexclusive world rights in all media and editions for the following material:
Full title of journal or book:

ISSN or ISBN:
Names of author(s):

Full title of article or chapter:

Volume:

Issue:

Year:

Figure number(s)
(if applicable):
Description of material to be reused:

Page range:
Table number(s)
(if applicable):

Article ID:

If you grant permission for reuse, the publication in which the material will be reused is shown
below:
Title of proceedings:

Publisher:

Media (select all applicable)


Expected publication date:

Print

CD

Online

Names of authors:

Full title of article (or chapter):

Would you please reply to me, with your answer and any special instructions, at the e-mail
address shown above?
Sincerely

(requestors name)

REPLY FROM ORIGINAL PUBLISHER: The above request is hereby approved on the conditions
specified below, and on the understanding that full credit (including author, publication, publisher,
copyright year, etc.) will be given to the source.
Approved by (print name):
Approved by (signature):
Date of approval:
Conditions and required credit line:

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