REQUEST FOR ONE-TIME USE OF PHOTOGRAPHIC IMAGE
State Historical Society of North Dakota
SFN 3736 (rev. 3-94)
| Requested by: __________________________________ |
_____Publication/broadcast |
| Address: ______________________________________ |
_____Exhibit |
| _____________________________________________ |
_____Other commercial use |
| Telephone: _____________________________________ |
Total fee: $__________ |
Type of use (Format, title, author and
date of publication):
|
Items used:
|
Credit line must read: State Historical
Society of North Dakota
Copy(s) of publication requested [Number requested ]
Conditions for permission to
publish
- Credit must be given to the State Historical Society of North Dakota
and to the creator of the item, if known.
- Permission is for one-time use only. The SHSND retains all rights to
the items and they are to be used only for the purpose listed in the
permission form.
- The SHSND reserves the right to limit the number of photographic
copies; to restrict the use or reproduction of rare or valuable items; to
ensure that materials from its files are reproduced in good taste; to make
special fee quotations on items involving unusual difficulty in copying; to
charge a higher fee than specified for a small number of rare or unique
items; and to deny a request because of copyright regulations, privacy
rights, or donor-imposed restrictions.
- The requestor is responsible for securing any necessary permission
from the creator of the work or heirs, if known. The creator's name will
be provided, if known. Consistent with these conditions for permission to
publish, the requestor agrees to indemnify and save and hold harmless the
SHSND (State Historical Board) and its officers and employees from any and
all claims of any nature arising under this agreement, including
specifically any action involving infringement of the rights of any person,
heir, or descendant under statutory copyright.
- If requested as marked above, the requestor will donate one or more
copies of the publication to the SHSND.
- The requestor is responsible for transcribing all desired identifying
information on a photograph. Detailed information will not be recorded
on the photograph order or permission form.
- The SHSND reserves the right to refuse to grant permission and/or
provide photographic reproduction services to publishers and individuals
who have not complied with these conditions in the past.
- Visual materials do not circulate. All reproduction work is done by
the SHSND or under its direct supervision. No attempt is made to
provide archival quality prints.
Approved for legal sufficiency. David E. Clinton, Assistant Attorney
General (3-10-94)
Requestor agrees to the conditions specified and agrees to pay a use fee
in addition to charges for reproduction.
Requestor:____________________________
Date: __________________
Permission is granted for the one-time use of the above
listed items owned by the State Historical Society of North Dakota.
Signed:_______________________________
Date: __________________
Notice: Warning Concerning
Copyright Restrictions
The copyright law of the United States (Title 17, U.S. Code) governs the
making of photocopies and other reproductions of copyright materials.
Under certain conditions specified in the law, libraries and archives are
authorized to furnish a photocopy or other reproduction. One of these
specified conditions is that the photocopy or reproduction is not to be
"used for any purpose other than private study, scholarship, or research."
If a user makes a request for, or later uses, a photocopy or reproduction
for purposes in excess of "fair use" that user may be liable for copyright
infringement.
This institution reserves the right to refuse to accept a copying order
if, in its judgment, fulfillment of the order would involve violation of
copyright law.