Skip to Main Content

Copyright Permission: Permission Letter Template

This guide lists and links to organizations that manage copyright permissions.

Permission Letter Template



Department of Permissions and Licensing

Hypothetical Publishing Company

### Some St.

Some City, Some State  12866


To Whom It May Concern:


I would like permission to use the following materials:

Full citation information:

Material to be used: [Chapters, page numbers, paragraphs, time stamps go here]


As concisely as possible, write a paragraph or two describing the following information:

  • are you using it as-is or making a derivative work (translation, adding accessibility features, adaptation, format conversion, sequel, spinoff, supplemental material…)?

  • will it be accessed online or face to face?

  • will it be to the public or a limited audience?

    • if it’s just a certain number of copies, how many copies?

    • if limited, how many people?

    • if limited, how is the limitation enforced (password? registered attendees of a conference? enrolled students in a class?

  • how are you providing access to it?

    • learning management system?

    • electronic reserves system?

    • public web site or blog? (provide the name and URL if you can)

    • reprinting it in a book or article? (provide information about it)

    • including it in a conference presentation?

    • display/performance/copies in a face-to-face setting?

  • is your use commercial in any way?

    • non-profit?

    • non-profit and educational?

  • what role or function does the copyrighted work fulfill?

    • supplemental learning materials?

    • core learning materials?

    • entertainment or reward?

    • illustrating something?

    • serving as an example of something?

    • component of a mash-up or remix?

    • basis for an adaptation or translation?


[If not using email: I have enclosed a self-addressed stamped envelope for your convenience in replying to this request.]



Your name