Permission to Use Copyrighted Material

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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