Copyright Declaration Form for Delivery of Requested Journal Articles

This form needs to be complted for each article you request to comply with the requirements of the Copyright Act 1968.

Please PRINT out a copy of this form and complete it by PRINTING all details clearly. SIGN the printed copy and forward it to the library where you collect the photocopy. If your photocopy is posted to you, please complete and forward this form to your branch of the State Library of Tasmania

Please note:

THIS FORM MUST BE LODGED AT YOUR LOCAL BRANCH OF THE STATE LIBRARY OF TASMANIA IN PERSON OR BY MAIL AND CANNOT BE TRANSMITTED ELECTRONICALLY

I understand that all documents requested by electronically through the Document Delivery Service at the State Library of Tasmania are subject to copyright restrictions, as per the Australian Copyright Act 1968, S 49(1).

Details

Declaration as required under S 49(1) of the Copyright Act 1968:

I require this copy for the purpose of research or study and will not use it for any other purpose. I have not previously been supplied with a copy of this article or other work, or the same part of the article or other work by an authorised officer of the library

Signature: ___________________________________    Date: _________________

State Library of Tasmania Branch: ______________________________________

Received by: _________________________________    Date: _________________