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Permission To Use Copyrighted Material
FOR GOOD CONSIDERATION, the undersigned, as copyright holder, hereby grants permission to [Name], to reprint, publish and use for world distribution the following material:
This material shall be used only in the following manner or publication:
A credit line to acknowledge use of the material is [ ] is not [ ] (check one) required. If required, the credit line shall read as follows:
[Your Phone Number]