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Copyright Permission Letter

A letter written to request permission to reprint or use certain copyrighted material is often called a copyright permission letter. This letter may be written by companies, organizations or individuals, such as authors, that wish to use published and copyrighted works for reprint, incorporation, or republishing purposes.

Format and Content

The proper copyright permission letter format should include the ISBN number (if applicable) of material that is copyrighted, the contact information of the individual requesting permission, what will be reprinted and where it will be used. It is also advised that a photo copy or excerpt of the actual copyrighted material is attached to the permission letter and that a Request Granted form also be sent with the permission request letter.


This copyright permission letter sample is written by a medical student who is studying at Ohio State University in Columbus, Ohio. Mark Hammbot is a sophomore in medical school and is majoring in prosthetics and biology recreations. He would like to use an excerpt of Don Mitchell’s article entitled, Breaking the Human Barriers in Medicine, an article published in Medical World Magazine. Mark wishes to use this excerpt by republishing it in a school paper article that will later be used in a presentation he will give to his class.

Dear Mr. Mitchell,

I am currently completing a dissertation that will be about a new breakthrough in prosthetics and manufacturing custom equipment to be used in the medical field. I plan on publishing this essay in my school paper here at the Ohio State University. This essay will also be published on our school website. I am writing you to request your permission to incorporate an excerpt from your following works:

Title: Breaking the Human Barriers in Medicine

Date Published: October 15, 2002

Published by: Medical World Magazine

Excerpt to be granted reprint permission: See attachment.

Please note that these rights should in no way limit or interfere with your current publishing rights of this work or with anyone else that has your permission to reprint or republish this work. By signing the below statements, you verify that you own the appropriate copyright to the above stated materials.

If you approve this request, please sign the letter below and mail it back to me with the envelope I have enclosed at your earliest convenience. If you are not the rightful holder of this copyright, please ignore this request and send the information of the rightful owner if known.

Thank you for your consideration of this request.


Mark Hammbot

Mark Hammbot

Medical Student

Ohio State University

Permission Granted:

I have the authority to authorize publishing rights and hereby grant that Mark Hammbot, student of Ohio State University permission to use and reprint the above requested material as described above this line.

The credit line should read as follows:


Copyright Holders Signature


Author’s Name