2. Permission for Published Illustrative or Textual Material

[date]
[your return address, with phone and fax numbers]

Dear Sir or Madam:

In a book I am preparing to be entitled [working title], scheduled for publication in [year] by the University of Virginia Press, I would like to include the following material, which originally appeared in [title] by [author or editor], published in [year]:

{for text: describe material by page and paragraph number, indicating start and end quotations}

{for illustrations: if you can, provide photocopies of images for which you request permission}

{if you wrote the material but the publisher retained copyright, also indicate here whether you are reproducing the original exactly or whether you have changed the original; indicate what percentage of the original is duplicated exactly in your new MS}

{for jacket or cover art only} I request nonexclusive world rights to use this material as jacket or cover art for my book published by the University of Virginia Press or its licensees, in all languages and for all editions. Because the UVaP is a nonprofit scholarly publisher and because my book will be published in a small edition, 000-0000 {ask your acquisitions editor for an estimate of the print run}. I hope you will waive any fees.

I request nonexclusive world rights to use this material as part of my work published by the University of Virginia Press or its licensees, in all languages and for all editions. Because the UVaP is a nonprofit scholarly publisher and because my book will be published in a small edition, 000- 0000 {ask your acquisitions editor for an estimate of the print run}. I hope you will waive any fees.

{for illustrations only, including jacket or cover art} The University of Virginia Press may wish to use this material in advertising for my book. Please indicate below if you grant permission for such use.

Please indicate your agreement by signing and returning this letter to me, specifying any credit line or other conditions you may require.

If you do not hold the rights for these texts/images, please forward this letter to the rights holder.

Sincerely yours,

[your signature]
[your name]

AGREED TO AND ACCEPTED:

BY ___________________    DATE

CREDIT AND/OR COPYRIGHT NOTICE: