Copyright Clearance Form

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Copyright Clearance Form

(you can highlight text on page, copy and paste into a blank text document)


Copyright Clearance Number:


Genre:
Credits:
Source:

Also wrote:


The following information--full names, date of death, sources and available web links for contributors--goes to Simon for clearance:

Title:

Author(s):

Publisher:

Published:

Printer:

Editor(s):

Illustrator(s):

Translator(s):

Photographer(s):

Artist(s) (of maps, diagrams, etc.):

Writer(s) of:

  • Preface:
  • Introduction:
  • Notes:
  • Commentaries:
  • Other:


Other info:

  • Source of Book:

If the book includes quotations, properly acknowledged (i.e., with author and source), and you have no reason to believe that the quoted person is still in copyright (e.g., a well-known author, long dead), you don't need to list them on the clearance.

Of course, if the quoted person is less well-known, or if you have any doubt about their PD status, you do need to check it out.

NOTE: all photographs are in the public domain 50 years after first publication (current Canadian copyright rules)

Date sent to Simon for clearance:

Other Books Already Done or Being Worked on?

PG Canada:
DP Canada:
PG-Int:
DP-Int (if access available):
David’s List (date of DP-Int copyright clearance):

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