COPYRIGHTED MATERIAL
FOR GOOD CONSIDERATION, the undersigned, as copyright
holder, hereby grants permission to _, to reprint, publish and
use for world distribution the following material: (Describe
or attach)
_
This material shall be used only in the following manner
or publication: (Define intended use)
_
A credit line to acknowledge use of the material is _____
is not _____ (Check one) required. If required, the credit
line shall read as follows:
_
Dated: _
_______________________________
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