To use this form, select the "Print" option from your browser file menu. Fill out the form and forward it via Fax or postal service to the appropriate copyright holder.

INQUIRY FORM ON OUT-OF-PRINT COPYRIGHTED MUSIC

Prepared By: Music Publishers' Association of the United States, and the National Music Publishers' Association Inc.


INSTRUCTIONS

This form is to be prepared in duplicate.  After completing the
boxed section and signing both copies where indicated, forward
them to the publisher who will complete the form and return it to
you.  If the publisher indicates a payment for the right you
request, and if the conditions are agreeable to you, remit the
amount to the publisher together with the original copy, which he
will have signed, whereupon the agreement will be completed.

__________________________________

If it is in print:
Please indicate the price per copy here __________

If it is out of print:
A)  Do you have plans to reprint it? ________  If so, when? _____________________
    At what price per copy?  $_____________

B)  If there are no plans for reprinting I (we) request your permission
     to have a non-exclusive right to reproduce by photocopy  ________  copies for use by 
     my/our_________________________________________________
     (students, members, congregation, etc.)

As consideration for your permission to do so, I (we) will pay you in  advance of making the 
copies  $____________ per copy, totaling $___________.   
The copies will be identical to your publication including the copyright notice.  The following will be legibly included on the first page of each copy of our reproduction:

"This reproduction is made with the express  consent of
_______________________________________________________________________________
in accordance with the provisions of the United States Copyright Law."              
I (we) acknowledge that I (we) are granted no right to sell, loan or otherwise distribute reproduced copies of the publication other than for the use set down above.  No other rights of any kind for any other use are included in this permission.

If you do not grant the above permission, will you supply me (us) with ____________ photocopies?

 _______  If so, at what price per copy? __________ 

___________________________________________

Accepted and Agreed to:    

By:  _________________________________________________________

Address:  _____________________________________________________

Date:  _________________________________