Faculty Course Reserve Services – Copyright Certification Form
COPYRIGHT RESTRICTIONS WARNING
The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material. Under conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction under the specified condition that it is not to be “used for any purpose other than private study, scholarship, or research.” If someone makes a request for, or later uses, a photocopy or reproduction for purposes in excess of “fair use”, that person may be liable for copyright infringement.
Bottom of FormINSTRUCTOR NAME
TELEPHONE (& EXT.)
COURSE NAME &NO.
SEMESTER/SUMMER SESSION
IDENTIFICATION OF REPRODUCED MATERIAL
Bottom of FormTITLE OF WORK
AUTHOR OF WORK
/SOURCE TITLE
COPYRIGHT NOTICE(as it appears on the source)
CERTIFICATION OF COMPLIANCE WITH COPYRIGHT LAW
This agreement is to protect F.D. Bluford Library, North Carolina Agricultural & Technical State University and the faculty concerning reproduction of copyrighted material. By signing this form, you accept legal responsibility for the reproduced material.
RELEASE WAIVER
I, ______(your name), state that I have been provided access to a copy of the minimum standard under Section 107 of the Copyright Revision Bill concerning “fair use” laws as adopted by F.D. Bluford Library, N.C. A&T S.U.
☐The photocopied material submitted on this form falls within “fair use” guidelines or is not copyrighted AND/OR
☐I understand that I will not be able to use these materials again without first obtaining permission from the copyright holder.
☐I have obtained prior permission from the respective copyright holder(s) and have attached a copy of the permission statement(s).
☐ The students are not assessed a fee beyond the actual cost of the photocopying.
SIGNATURE
/DATE
Return to: Access Services (Circulation Desk, 1st Floor Bluford Library) 336.285.4166
copyright certification Form / 2