Permission to Publish Form

Before requesting permission to publish materials from the Lilly Library, please read and understand the following documents:

Required fields are marked with an asterisk.
I wish to reproduce from the following Lilly Library material(s)
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In the field below, please provide as much information as possible about each material, including:

  • Author, title, place of publication, date of publication
  • Name of collections and/or call number
  • Page number or description of item to be reproduced, quoted, or cited.
If you opt to upload an external file containing the list of materials, please type "See attached" for the description field below.
(OR) Attach a list of materials.
One file only.
50 MB limit.
Allowed types: pdf, doc, docx, xls, xlsx.
No file selected
I wish to include these materials in the following publication
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In the field below, please include as much of the following information as possible about the publication where the Lilly Library materials will appear, including:

  • Author and title of planned publication
  • Publisher
  • Date of publication
  • Edition (i.e., first, second, reprint, etc.) 
Publication is
My Information
Address
State/Province
Country
Note to the library
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Please write a note in the field below or attach a letter formally requesting permission to publish material addressed to:

Director, The Lilly Library
1200 E. 7th Street, Indiana University
Bloomington, Indiana 47405-5500.
(OR) Attach a letter.
One file only.
50 MB limit.
Allowed types: pdf, doc, docx, xls, xlsx.
No file selected
In requesting permission to publish a copy of the item or items described and by submitting this form, I hereby agree to indemnify and hold harmless the Lilly Library from any action relating to infringement of the rights of any person or entity who may claim legal rights in these item or items under common law or under statutory copyright. These persons or entities may include, but are not limited to, authors, editors, contributors, designers, illustrators, photographers, photographic subjects, artists, printers, publishers, and binders, or their heirs, successors, and assigns.