Permission request Name
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Which material exactly would you like to use for the reprint?
Author of the book
Title of the book
Year of publication
or
Title of the journal
Issue no./publ. year
Author of the article
Title of the article
Page(s)
Figure(s) page(s)
Table(s) page(s)
text passage(s) page no
What will the material be used for? a. for commercial publication
in a book / on a CD / in a slide set or other
Title and kind of work (commercial use)
Author of the work (commercial use)
Publication date scheduled
Print run / number of copies
within an internet presentation
Internet address
b. for scientific publication in a scientific journal
Title of the journal (scientific use)
Issue of the journal
Title of the article
Author/s of the article (scientific use)
c. for publication in a non-scientific journal
Title of the journal (non-scientific use)
Issue of the journal:
Title of the article
Author(s) of the article (non-scientific use)
Circulation
d. for non-commercial lectures/instructions (e.g. speeches)
e. for internal purposes or for a private archive
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In which language is the material to be published?
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