Note that there are three tabs at the bottom of the Excel document. Please fill out each worksheet with a response in each cell. Please return the completed form as an attachment, together with all relevant permissions documentation.
Copyright Information Tab
Completion of this tab is required.
- Date of birth: for copyright registration of your work
- Country of citizenship: for copyright registration of your work
- Previously copyrighted content: is this work a revision of a dissertation that has previously been copyrighted? If so, please send a copy of either the previous LOC certificate or the certificate number and year of registration.
Text Permissions Tab
If there are no text permissions required, please indicate “no text permissions.
- Location: page numbers or figure number from manuscript
- Brief description: the beginning and end of the quotation
- Source: publication details for original source (title, publisher, year of publication, URL)
- Copyright holder: rightsholder (publisher, individual, organization)
- Credit Line: source attribution, usually provided on permissions licenses
- Location for Credit Line: If license does not specify where the credit must appear, indicate “NA.”
- Written permission received: Written permission is required. Email authorizations are acceptable provided that print and digital rights have been requested in the initial inquiry.
- Print rights: okay for print formats? This is required for all content.
- Digital rights: okay for digital formats? This is required for all content.
- Audio rights: not applicable for all titles – please check with your editor
- Territory: request World rights
- Print Run Restrictions: print run will be noted in publication details
- Language Rights: we prefer rights to all languages, but English rights to be secured minimally
- Notes: anything else of importance or that needs to be explained
Figure Permissions Tab
If no figures require permission, please indicate “no figure permissions.”
- Figure or plate no. in ms: figure numbers should be numbered consecutively per the chapter in which they appear
- Brief description: figure caption or description
- Reprinted, original, adapted, or redrawn: Original (author owns rights); Reproduction (a scan, copy, or slide from a third party (may need permission); Redrawn: Redrawn from third party image (may need permission); Modified: Redrawn with changes (may need permission).
- Image display restrictions: any limitations noted in permissions license regarding placement, color or size limitations
- Is a comp copy required? Any rightsholder who requests a book upon publication – please include full address here
- Are rights transferable to third parties? Can foreign publishers use the images in translated editions or will they have to secure new permission?
- Do we have publicity/promotional rights? Can this image be used in advertising for your book?
Please contact your editorial assistant if you have any questions about completing the form.