Form JD-ES-209 "Reprints and Permission Request" - Connecticut

What Is Form JD-ES-209?

This is a legal form that was released by the Connecticut Judicial Branch - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the Connecticut Judicial Branch;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-ES-209 by clicking the link below or browse more documents and templates provided by the Connecticut Judicial Branch.

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Download Form JD-ES-209 "Reprints and Permission Request" - Connecticut

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REPRINTS AND PERMISSION REQUEST
CONNECTICUT JUDICIAL BRANCH
DIVISION OF EXTERNAL AFFAIRS
JD-ES-209 Rev. 6-17
231 Capitol Avenue Hartford, CT 06106
NOTE: All republished material must carry Judicial Branch credit.
www jud.ct.gov
Unless specifically noted otherwise, all permission is
given for one-time use only.
Telephone Number: (860) 757-2270
Fax Number: (860) 757-2215
Requestor Identification
Name of requestor (Last, first, middle initial)
Date of request
Organization/Agency/Division
Telephone number
Street address
Fax number
City
State
Zip
E-mail address
Request Description
1.) List the material that you are seeking to reprint:
2.) State the purpose and manner in which the material will be used:
3.) Describe the mission of the organization seeking permission:
4.) State whether the material requested will be used for commercial purposes and if so, in what manner:
5.) Will a profit be derived from the use of the copyrighted material?
6.) Will there be a charge for the product or program that includes the copyrighted material?
7.) If the requested material is to be placed in a publication, provide the name of the publication, and the context in which the material
will appear:
8.) Will the requested material be published on a website or in other digital/electronic format? If so, is there a charge to use the website or
other e-service?
9.) Estimated number of copies to be printed or produced. (If Intranet, number of users):
10.) Date(s) the material will be distributed:
Print Form
Reset Form
REPRINTS AND PERMISSION REQUEST
CONNECTICUT JUDICIAL BRANCH
DIVISION OF EXTERNAL AFFAIRS
JD-ES-209 Rev. 6-17
231 Capitol Avenue Hartford, CT 06106
NOTE: All republished material must carry Judicial Branch credit.
www jud.ct.gov
Unless specifically noted otherwise, all permission is
given for one-time use only.
Telephone Number: (860) 757-2270
Fax Number: (860) 757-2215
Requestor Identification
Name of requestor (Last, first, middle initial)
Date of request
Organization/Agency/Division
Telephone number
Street address
Fax number
City
State
Zip
E-mail address
Request Description
1.) List the material that you are seeking to reprint:
2.) State the purpose and manner in which the material will be used:
3.) Describe the mission of the organization seeking permission:
4.) State whether the material requested will be used for commercial purposes and if so, in what manner:
5.) Will a profit be derived from the use of the copyrighted material?
6.) Will there be a charge for the product or program that includes the copyrighted material?
7.) If the requested material is to be placed in a publication, provide the name of the publication, and the context in which the material
will appear:
8.) Will the requested material be published on a website or in other digital/electronic format? If so, is there a charge to use the website or
other e-service?
9.) Estimated number of copies to be printed or produced. (If Intranet, number of users):
10.) Date(s) the material will be distributed:
Print Form
Reset Form