Inquiry Form For Out-of

Inquiry Form For Out-of-Print Music
Prepared by: Music Publishers’ Association of the United States and 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.
To: __________________________ [Name of Publisher]
Address:
I (We) wish to procure __________ copies of your copyrighted publication:
_______________________________________________ [Title]
________________________________________ [Arrangement]
by: _____________________________________. [Composer]
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.)
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 ____________________ [Copyright
Owner’s Name] in accordance with the provisions of the United States Copyright Law.
”I (We) acknowledge that I (we) am 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 permission to make copies can be granted, will you charge a fee? ________________
If so, how much? ________________
If you do not grant the above permission, will you supply me (us) with photocopies?
________________
If so, at what price per copy? $ ________________
By:
Accepted and Agreed to:
Address:
Date: