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COPYRIGHT DECLARATION
padlock (Published work including Ordnance Survey maps)
* NAME (Block Capitals)
* ADDRESS
Ref.  number of document or description
I declare that:-

(a) I require the copy solely for the purposes of research or private study or for a non-commercial purpose.

(b) I will not supply a copy of it to any other person.

(c) I have not previously been supplied with a copy of the same material by the Record Office or anyone else.

(d) To the best of my knowledge neither I nor any other person with whom I work or study has made or intends to make, at or about the same time as this request, a request for substantially the same material for substantially the same purpose.

I understand that if the declaration is false in a material particular the copy supplied to me by you will be an infringing copy, and that I shall be liable for infringement of copyright as if I had made the copy myself.



Signature*:............................................................


Date:........................................................

*This must be the personal signature of the person making the request. A stamped or typewritten signature, or the signature of an agent, is NOT acceptable

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