Copyright Permission Request Form

Contact Information  
   
First Name:
Last Name:
Name of Company or Organization:
   
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
   
Contact Phone Number:
Fax Number:
Email Address:
   
Your Reference Number (if any):
   
GASB Document Information  
   
GASB title from which you would like to reprint:
Specify requested pages or range of pages, paragraph numbers, or specific sections as appropriate:
   
Your Document Information  
   
Title of Your Work and edition number:
Author:
Publisher:
Initial print run and total number of pages:
Publication Date:
Format of Your Work:  
    Print:  
     (hardbound or softbound edition, loose-leaf edition)
    CD-ROM:  
     What is the size of the print run (number of copies)?
    Online:  
     What is the URL where the material would be located?
   
General description of the content—other material that will be included in your work with the requested GASB copyrighted material:
   
Selling price:
   
Anticipated audience (accounting, academic, legal, etc.):
Please enter the words you see in the box, in order and separated by a space. If you are not sure what the words are, click the reload button next to the distorted words.
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