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Authorization Form for Copyright Release


printable (PDF) version

Instructions:

  1. Applicant fills out information regarding request in Section A of this form.
  2. Applicant sends form to copyright holder to fill out Section B of this form. Copyright holder returns the signed form to the applicant.
  3. Applicant sends completed form to:
The Alexander Architectural Archive
University of Texas Libraries
The University of Texas at Austin
P.O. Box P (BTL 200 S5430)
Austin, TX 78713-8916

SECTION A: TO BE COMPLETED BY THE APPLICANT:

I am working on the following project:

For this project, my intentions for the following materials include:

          Material          Intentions: reproduce; reproduce and publish; publish; other (please explain)

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

I agree not to quote from or publish the above listed materials without first completing the Notification of Intent to Quote from or Publish form for the Alexander Architectural Archive. I can be reached at the following address below if you have any questions.

___________________________________        _________________________
Applicant's Signature:                                        Date:

Applicant's printed name:

Phone number:

Address:

SECTION B - TO BE COMPLETED BY THE COPYRIGHT HOLDER:

Dear Copyright holder,

The Alexander Architectural Archive requires that an applicant supply written authorization from the copyright holder for duplication, and intentions of quoting from or the publishing of original materials in the Alexander Architectural Archive.  If you are agreeable to my intentions listed in SECTION A please complete and sign the form below:

Dear Applicant and Alexander Architectural Archive staff

I represent and warrant that I control the copyright for the materials listed in SECTION A.

Please initial your decision(s) below:

____ I give my permission for the applicant to use the materials from the Alexander Architectural Archive as listed in SECTION A of this form.

____ I DO NOT give my permission for the applicant to use ANY of the materials from the Alexander Architectural Archive as listed in SECTION A of this form.

____ I give my permission for the applicant to use the materials from the Alexander Architectural Archive as listed in SECTION A of this form, with the following exceptions (examples may include: permission to reproduce, but wish the applicant to submit a separate request for publication; permission to reproduce only items 1-8; etc.):

The applicant above has contacted you because the University of Texas owns material for which it does not hold the copyright. In an effort to expedite scholarship, you may transfer your copyright to the University of Texas. Please initial your decision below.

____ I wish to, convey and assign to the University of Texas at Austin, on behalf of the University of Texas Libraries, any copyright that I control for materials held at the Alexander Architectural Archive.

____ I do not wish to convey my copyright.  Please continue to contact me with copyright requests.

____ I have questions regarding copyright. Please contact me.

___________________________________        _________________________
Copyright holder's Signature:                             Date:

Copyright holder's printed name:

Phone number:

Address:

PLEASE RETURN THIS SIGNED FORM TO THE APPLICANT LISTED IN SECTION A