Your name / Phone number
Company name / Fax number
Your position / E-mail address
Address, including postcode / Website address
VAT number
Please quote any reference numbers from your previous contact with us.
Details of our products that you want to reproduce
(or other people’s products that are originally made from our products)
Product number / Title / Format
(see the note below) / Edition date
(for example, 2002 or latest date) / Features or page numbers you want to reproduce
If we supplied the original material, please tell us what format we supplied it in (for example, on paper, as a photograph, as a micrograph).
Do you own all of the material you showed above? / Yes o No o
Will you continue to own it for the next year? / Yes o No o
Details of the products you want to make
What is the name of the product, article or website where the reproduced material will appear?
What is the purpose of your product (for example, who will use it and how will they use it)?
Can you use the product to help navigate? / Yes o No o
Which of the following best describes the purpose you want to reproduce our material for?
o / Educational / o / Research and development / o / Promotional / o / Statutory or legal
o / Broadcasting / o / Commercial sale or distribution / o / Personal use / o / Other (please give us details below)
Format of your product
Please explain how you will reproduce the material, including details on what items you will add or remove from the reproduction, the final size (and resolution for digital copies) of any images and what material or method you will use (for example, paper, CD-ROM, film, the Internet).
If our material is only a small part of the total product, please explain what other parts are contained within your product, and provide an estimate of the proportion of the product made up of our material (for example, 2¼ pages of a 220-page book, 25% of the image or 15 minutes of a 60-minute film).
Selling or distributing your product
How will you sell or distribute the reproductions (if this applies) and for how long?
How many copies will you make and distribute?
In total / Most in
any one year
How much will you charge for the product? (Please give an estimate if you do not know.)
Retail price / Wholesale price
Contractors
Are you using a contractor to do the reproduction? / Yes o No o / Are you working as a contractor for somebody else? / Yes o No o
If ‘Yes’ to the above questions, what is their address?
Extra information
Please use the space below to give us any extra information that may help us process your application more quickly, or to continue your answers to earlier questions.
Declaration
As far as I know, the information I have given is true and accurate.
Your signature / Date
Please return this form to the Copyright Section, by post to the UK Hydrographic Office, Admiralty Way, Taunton, Somerset, TA1 2DN, United Kingdom, by fax to +44 (0)1823 354045 or by e-mail to
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