Georgia State University Library

Permission Form for Photographs

Date: August 30, 2007

I am requesting permission to reprint the following photographs or document images.:

Photographic Images:

LBSC89-067a

N15-130_b

N53-059_a

N53-059_b

Thumbnail views of each of these photographs are attached.

This material is to appear as originally published (any changes or deletions are noted above) in the following work that Mercer University Press, a nonprofit publisher, is preparing for publication:

Title: The Centennial History of the Court of Appeals of Georgia 1906-2006

We request nonexclusive rights, as part of our volume only, in all languages and for all editions.

If you are the copyright holder, may we have permission to reprint the above material in our book? If you do not indicate otherwise, we will use the usual scholarly form of acknowledgment, including the publisher, the author, title, etc.

If you are not the copyright holder, or if additional permission is needed for world rights from another source, please so indicate.

A duplicate copy of this form is enclosed for your records.

Thank you for your consideration of this request.

The above request is hereby approved on the conditions specified below, and on the understanding that full credit will be given to the source.

Date:_________________ Approved by: (Name)______________________________________

(Title) ________________________________________________________________________

(Address) _____________________________________________________________________

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