FOR GOOD CONSIDERATION, the undersigned irrevocably
authorizes _, and its successors and assigns to use, publish
or reprint in whole or in part the following statement,
picture, endorsement or quotation: (Describe or attach)
_
This authorization shall extend only to a certain
publication known as _, including all new editions, reprints,
advertisements, publicity and promotions thereto of said work.
Dated: _
_______________________________
FOR GOOD CONSIDERATION, the undersigned, as copyright
holder, hereby grants permission to _, to reprint, publish and
use for world distribution the following material: (Describe
or attach)
_
This material shall be used only in the following manner
or publication: (Define intended use)
_
A credit line to acknowledge use of the material is _____
is not _____ (Check one) required. If required, the credit
line shall read as follows:
_
Dated: _
_______________________________
Permission to Discuss Consumer File
TO: (name of consumer agency)
Permission is hereby granted for (name of consumer reporting
agency) to discuss the information about me contained in
their file in the presence of (name of third party)
_______________________
(Signature)