1. The published work described below (the "Work") is the subject of this agreement:
The Owner is the sole copyright holder of the Work.
2. The Owner hereby grants permission to the Requestor to use the following selection from the Work:
3. The Requestor may use the Material only as follows, without deletions from, additions to, or changes in the text:
4. The Requestor may
5. As consideration for the grant of the Owner's permission to use the Material, the Requestor shall pay to the Owner a one-time fee of
6. This agreement provides nonexclusive
7. Every copy of the Material used must include, either on the copyright page or as a footnote on the page on which the Material begins or, if in a periodical, on the first page of the quotation, the following credit line:
8. The Owner makes no representations about the Requestor's use of the Material. More specifically, the Owner has not obtained any releases covering the Requestor's use of the Material and the Owner does not represent that the Requestor's use of the Material will not infringe the rights of any third parties. The Requestor shall indemnify the Owner against any claims, damages, liabilities, losses, or expenses (including reasonable attorneys' fees) that may arise out of the Requestor's use, reproduction, or distribution of the Material.
9. This agreement will terminate automatically if the
10. On termination of the agreement, all rights granted under this agreement, including the Requestor's right to use the Material, will end. The Requestor shall promptly discontinue its use of the Material and may no longer reprint, publish, or distribute the
11. The laws of the state of
12. The Requestor shall furnish to the Owner one complimentary copy or tear sheet for each publication, except motion pictures, in which the republished Material appear, on or before publication of the republished Material. If permission has been granted for electronic reproduction, the Requestor shall furnish the Owner with the internet or other electronic address at which the republished Material will appear.
13. Nothing in this permission conveys any intellectual property rights or other interests to the Material or Work, and the Requestor may not reproduce, distribute, sell, or transfer all or part of the Material or Work. The Owner retains its own right to publish the Material or Work, or to grant permission for others to publish the Material or Work. The permission granted in this release is neither severable nor transferable to a third party. Any attempted transfer is void and of no effect.
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Each party is signing this agreement on the date stated opposite that party's signature.
OWNER | |||||||
By:____________________________________________________ | |||||||
Name: | |||||||
Title: | |||||||
REQUESTOR | |||||||
By:____________________________________________________ | |||||||
Name: | |||||||
Title: |
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EXHIBIT A
Attach copy of Material