Copyright Permission Form

COPYRIGHT PERMISSION REQUEST FORM

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First name *

Last name *

Company or organization name

Street address *

City *

State/province *

Zip/postal code *

Country

Contact phone number

Email address *

Your reference number (if any)

Indicate if the reprint materials are from FAF, FASB, or GASB *

Title of applicable FAF/FASB/GASB Work *

Page(s), paragraph numbers, or sections being requested (and indicate total number of pages of FAF/FASB/GASB content)

Title of your work (and edition number, if applicable) *

Requested "run" dates (when will the content be made available)

Author(s)

Publisher

Total number of pages in Work *

Publication date *

Number of copies expected to be distributed (recipients) *

Format(s) of Work*

Print

Digital

(include URL where the material would be located)

General description of content, including other material that will be included in the Work *

Audience (e.g. accounting, academic, legal) *

Method of distribution (e.g. stand alone document, workshop-related materials, classroom materials) *

Selling price / cost associated with access (if for an event)