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Copyright Resources: Sample Permission letters

This guide is designed to help build an understanding of copyright as users and makers of copyrighted content

More sample forms

Duke University scholarly communications blog: The following sample request for permission letters, release forms and licenses are intended as models. They are not form letters, since each such document should take account of specific situations and circumstances:

Author Addendum

publisher/copyright holder permission template - replace text in brackets

[Day Month Year

Firstname Lastname, editor or rights holder



Email/snailmail address]


Dear [Title Lastname,]

My name is [Firstname Lastname] and I am writing to you from the Claremont Colleges Library located at 800 North Dartmouth Avenue, Claremont, CA 91711 [or your institution and address].

I would like permission to include the following material in our institutional repository, Scholarship@Claremont,

[Citation of material for which permission is sought, specifying exactly what material would be used]

Scholarship@Claremont is non-commercial and intended for educational purposes. It is meant to reflect the scholarship produced at The Claremont Colleges by students, faculty and researchers. Scholarship@Claremont is not password protected and openly accessible on the internet.

If you do not control the copyright on all of the above mentioned material, I would appreciate any contact information you can give me regarding the proper rights holder(s), including current address(es). Otherwise, your permission confirms that you hold the right to grant the permission requested here.

Permission includes permanent non-exclusive world rights to archive, preserve, disseminate and promote the material and will not limit any future publications-including future editions and revisions-by you or others authorized by you.

I would greatly appreciate your consent to my request. If you require any additional information, please do not hesitate to contact me. I can be reached at:

[Your contact information]


[FirstName LastName]




[Phone Number]



Pomona College – 1887 • Claremont Graduate University – 1925 • Claremont University Consortium – 1925 • Scripps College – 1926

Claremont McKenna College – 1946 • Harvey Mudd College – 1955 • Pitzer College – 1963 • Keck Graduate Institute - 1997

Your Librarian

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Beth Namei
Research, Teaching, & Learning Services - North Offices
Mudd Library, 3rd Floor