Fair Use Acknowledgement Form

When submitting materials to be used under the Fair Use doctrine, please read and submit the following form with your course packet request.

Acknowledgement of Requesting Instructor or Staff Member

You have requested that Indiana University Bloomington (IUB) reproduce certain educational materials (henceforth “instructional media”) for you in your capacity as an IUB instructor or staff member. By this acknowledgement, you certify that you are using these materials for educational purposes only. Further, to the extent that you are using instructional materials authored by someone other than yourself, serious questions of copyright may exist. In general, the work of a third party may only be reproduced if:(a) you have express, written permission to reproduce that work for your intended purpose; (b) the work is in the public domain; or (c) your reproduction of the work would be considered to be “fair use” under the law of copyright.

To determine whether the use of copyrighted works for teaching or research is “fair use” requires a case-by-case application and balancing of four factors as set forth in the copyright statute. A proper determination of fair use requires that these four factors be applied to the specific circumstances of the intended use. The factors are:

  1. the purpose and character of the use, including whether such uses is of a commercial nature or is for nonprofit educational purposes;
  2. the nature of the copyrighted work
  3. the amount and substantiality of the portion used in relation to the copyrighted work as a whole
  4. the effect of the use upon the potential market for or value of the copyrighted work

The concept of fair use does not give educators a blanket exemption from the copyright law. Purposes such as teaching and research may be “favored” purposes under the copyright law, but that law still applies and protects the original author’s interests in her intellectual property.

Additional information on copyright generally, and fair use specifically, can be found at the website of the Copyright Management Center of Indiana University, which is located at Specific questions relating to copyright and the application of fair use can be discussed with attorneys at the Office of University Counsel. The phone number is 812-855-9739.

I have reviewed the material set forth above and know, or reasonably believe, that my present request to reproduce instructional materials does not violate United States copyright law.

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Date Signature of Instructor or Staff Member