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Champaign
County
Historical and Genealogical Index
Reproduction Use Form
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Name of
Applicant |
Organization
or Agency (If Appropriate) |
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Address |
City |
State |
Zip |
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E-mail
Address |
Phone |
Fax |
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Description of Materials (attach additional pages if necessary)
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Intended Use of Material:
Check one: _____ Commercial ___ Educational/Non-Profit ____ Personal Use ____ Book ____ Magazine
____ Film/Video Program ____
CD-ROM/Website ____Advertisement
____ Newspaper/News Media ____Dissertation/Thesis ____ School Project ____Exhibit ___Other __________________________ |
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Author/Director/Producer
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Title
or Description of Use
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Publisher |
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Projected
Date of Publication
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USE
FEE
______ Personal/Educational Use (includes
Dissertations, Theses, Scholarly Journals, and classroom uses): No Fee
______ Non-Profit
Use (including University Presses): $25.00
per image
______ For-profit Corporations/Commercial Use: $50.00 per image
By signing this application, I accept the conditions
on the reverse:
______________________________________________________ _______________________
Signature Date
Permission
Granted:
______________________________________________________ _______________________
Photographic
Use Policy
Patrons may request photocopies, copy prints, slides,
and digital images for most photographs in the Champaign County Historical Archives. Copies of photographs are provided for
personal and educational use. Patrons planning to reproduce/publish photographs
in books, articles, exhibits, videos, electronic transmission (publishing an
image on a web site, for example) or other media must request permission in
advance by submitting this Reproduction Use Form. Permission will normally be
granted as long as applicable use fees are paid and donor or copyright
restrictions do not prohibit the intended use.
The long-term preservation of the
image is the primary concern of the archives and as such, the archives reserves
the right to limit reproduction due to age, condition or format.
Permission for
reproduction is for one-time use and
is limited to the applicant and is nontransferable. Permission for reproduction is granted only
for the expressed purpose described in this application. Any subsequent use
constitutes reuse and must be applied for in writing. Any change in use from that stated on the
application requires permission of the Champaign County Historical Archives. An
additional fee may be charged for reuse or change in use. This permission is non-exclusive; the
Champaign County Historical Archives reserves the right to reproduce the image
and to allow others to reproduce the image.
The
publishing party assumes all responsibility for clearing reproduction rights
and for infringement of the U.S. Copyright Code. Please note that physical ownership of the
image by The Champaign County Historical Archives does not imply copyright, and
it is the applicant’s responsibility to determine copyright ownership. In addition to the permission of the
Champaign County Historical Archives, additional permissions may be required. It is the responsibility of the applicant to
obtain permission. The Champaign County
Historical Archives will aid the applicant in contacting individuals pertaining
to permissions by providing addresses, when available. The Champaign County Historical Archives assumes
no responsibility for infraction of copyright laws, invasion of privacy, or any
other improper or illegal use that may arise from reproduction of any image. Please see the U.S. Copyright Office web site
at http://www.copyright.gov for more information.
In
all instances, the applicant agrees to hold the Champaign County Historical
Archives and its agents harmless against any and all claims arising or
resulting from the use of this image and shall indemnify the Champaign County
Historical Archives and its agents for any and all costs and damages arising or
resulting from any such unauthorized use.
All reproductions
must include
The
applicant agrees to send the Champaign County Historical Archives one copy of
the work containing the reproduction.
Questions
regarding record reproduction or publishing should be directed to:
Director
The
210
(217)
367-4025
| Champaign County Historical
and Genealogical Index |
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