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Request for
Photographic Copies 

Special Collections does not currently have a secured link in place to accept payment for photographic copies by credit card. We suggest you download the Request for Photographic Copies PDF file, print the form, complete it, and send with your check or money order to:

Special Collections
The University of Texas at Arlington Libraries
Box 19497 * Arlington, Texas 76019-0497
Phone: (817) 272-3393 * Fax: (817) 272-3360
E-mail: Reference Desk

You may be entitled to know what information UT Arlington (UTA) collects concerning you. You may review and have UTA correct this information according to procedures set forth in UT System BPM #32. The law is found in sections 552.021, 552.023 and 559.004 of the Texas Government Code. For more information, see our Privacy Policy

Name:
Address:
City: State: Zip:
Phone: Fax:
E-Mail:
Description Format Size #Copies Unit $ Neg. $ Total
             
             
             
             

Total Print Fee  
Sales Tax  
Publication Fee  
Mailing Fee  
TOTAL DUE  

Make Checks payable to UTA Libraries.
Please add driver's license number to check.
Payment is required in advance.


Special Instructions:

 
 

Statement of Intended Use (Include medium, title, publisher, and project date):

 
 

I have read and agree to the Print Service Agreement which follows governing the reproduction of items held by Special Collections as applied to the work described above.

Signature: Date:

 

Print Service Agreement

  1. I understand that each item must be reproduced in its entirety and the reproduction may not be bled off or altered in any way. Nothing may be superimposed on the reproduction. Reproductions may not be printed in colored ink or on colored stock. Permission to reproduce a detail will be granted only if the entire image also appears in the same publication. Application to reproduce a detail from a work will be considered only upon receipt of a photo copy or photograph marked to show the area to be reproduced. If a detail is used, the caption must include the word "detail.
  2. I understand that on occasion requests for copies may be denied because of copyright regulations or physical condition of the items.
  3. I understand that The University of Texas at Arlington Libraries, Special Collections Division, assumes no responsibility for any royalties claimed by the creator of the items or on his behalf.
  4. I agree to assume all responsibility for clearing reproduction rights and for any infringement of the U.S. Copyright Code. I also agree to protect the rights and privacy of all subjects depicted in the materials furnished.
  5. I agree that if permission is granted for the publishing party itself to photograph any visual material in Special Collections, all such negatives will be turned over to Special Collections.
  6. I agree that when five or  more items from Special Collections are published in a publication, one copy of the publication must be presented without charge to the Special Collections Division.
  7. I understand that permission is granted for one-time use, for one edition, and in one language. Additional language editions, subsequent editions, and any related promotional use must be considered as separate requests and will require the payment of additional fees.
  8. I understand that these materials are not to be resold.
  9. I understand that the credit line, as stated below, must appear in an appropriate portion of the publication, with credits section either at the beginning or end of film strips, television programs, motion pictures, videotapes, or other visual formats using Special Collections visual materials.
  10. I understand that failure to comply with any of the above regulations will result in withdrawal of permission to reproduce, and appropriate legal actin will be taken.

The following credit MUST be shown in an appropriate portion of the publication: (Staff will check the appropriate line)

____  Courtesy, Special Collections, The University of Texas at Arlington Libraries, Arlington, Texas.
____  Courtesy, Fort Worth Star-Telegram Photograph Collection, Special Collections, The University of Texas at Arlington Libraries, Arlington, Texas.
____  Use the Credit Line noted below:

 

For Staff Use Only:

______ Job Number
______ Pick up by Patron
______ Mail to Patron
______ Tax-exemption Form [provided by non-profit organization & completed]
______ UTA Student/Faculty/Staff
______ Non-UTA

Thank you for your interest in Special Collections materials!


Special Collections
The University of Texas at Arlington Libraries
Phone: (817) 272-3393 * Fax: (817) 272-3360 * E-mail: Reference Desk

This page last update on Friday, April 16, 2004


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Last Modified: 16 Apr 2004 13:44:04
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