Copyright Permission Agreement for Thesis or Dissertation

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Permission to Digitize Book
Author: _____________________________________________ Publication Date: ___________
Title: _________________________________________________________________________
______________________________________________________________________________
Permission to scan and redistribute. I grant to the University of Iowa the nonexclusive right to
create a digital version of the above-named publication (the “Work”) and to make it available as part
of its digital library collection. I further grant the University of Iowa permission to provide a copy of
the Work to the University of Michigan for deposit in HathiTrust, and I hereby grant the University
of Michigan permission to produce digital copies for its collection and for HathiTrust. I understand
this will result in the Work being available to the public in multiple repositories, in digital form and
without restrictions. I authorize the University of Iowa, the University of Michigan, and/or agents
acting on their behalf (collective, the “Libraries”) to reproduce, distribute, display, and transmit the
Work in order to make it freely available online.
Non-exclusive and perpetual license. I understand that this permission constitutes a nonexclusive, perpetual, royalty-free license, and that I retain all other rights to the copyright in the
Work, including the right to use it in other works such as articles and books.
Authority to grant license. I represent and warrant that I am the sole author and owner of the
copyright in the Work, and that I have full and sole authority to grant this permission. I also
represent that the Work does not, to the best of my knowledge, infringe or violate any rights of
others. I have obtained any third-party rights, if necessary.
Permission Granted By
_____________________________________
(Print Author’s name)
______________________________________
(Signature of Author)
_____________________________________
Address:
______________________________________
City/State/Zip
___________________
Date:
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Phone Number or E-mail address
Mail or email a completed, signed form to:
The University of Iowa Libraries, Digital Library Services
100 Main Library
Iowa City, Iowa 52242
lib-ir@uiowa.edu
If you would like to grant additional access, please initial here _____ and complete the addendum on
the following page.
ADDENDUM
Please indicate your choice by putting your initials next to the terms you select.
1. I authorize the above-named Libraries to make and distribute reprints or other paper copies of
the Work for non-commercial scholarly purposes. ___ Yes ___ No [NOTE: If you leave blank, the
default is “No.”]
2. I hereby choose to release the Work under the following Creative Commons terms (select only
one). [NOTE: If you leave blank, the default is the final option of “not interested.”]
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution 4.0 license. This license, CC BY, lets others distribute, remix, tweak, and build upon your
work, even commercially, as long as they credit you for the original creation. For the license details, see:
http://creativecommons.org/licenses/by/4.0/.
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution NonCommercial 4.0 license. This license, CC BY-NC , is the same as CC BY but limited
to non-commercial uses. For the license details, see: http://creativecommons.org/licenses/by-nc/4.0.
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution No Derivatives 4.0 license. This license, CC BY-ND, allows for redistribution, commercial
and non-commercial, as long as it is passed along unchanged and in whole, with credit to you. For the license
details, see: http://creativecommons.org/licenses/by-nd/4.0.
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution NonCommercial No Derivatives 4.0 license. This license, CC BY-NC-ND, is the same
as CC BY-ND but limited to non-commercial uses. This is the most restrictive of the Creative Commons licenses.
For the license details, see: http://creativecommons.org/licenses/by-nc-nd/4.0.
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution Share Alike 4.0 license. This license, CC BY-SA, lets others remix, tweak, and build upon
your work even for commercial purposes, as long as they credit you and license their new creations under the
identical terms. For the license details, see: http://creativecommons.org/licenses/by-sa/4.0.
___ I choose to release my work to the public under the terms of the Creative Commons
Attribution NonCommercial ShareAlike 4.0 license. This license, CC BY-NC-SA, is the same as CC
BY-SA but limited to non-commercial uses. For the license details, see: http://creativecommons.org/licenses/bync-sa/4.0.
___ I dedicate the Work to the public domain. I understand that the Work will no longer enjoy
copyright protection and may be reproduced and distributed without my permission and without
compensation. I understand that dedicating the Work to the public domain is irrevocable.
___ I am not interested in releasing the Work under a Creative Commons license at this time.
Since the permission have grant to the above-named Libraries is non-exclusive, I understand
that I retain all other rights including the right to transfer rights or license my work to others
and/or to release my work in the future under a Creative Commons license.
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