Granted to (Agency/Client):                                                                            Photographer name:




                                                                                                                         Photographer ref. no:


                                                                                                                         order / invoice no:

The Advertiser (Client):                                                                                     Product:

Description of photograph/s covered by the licence:



Terms of the licence:                    

Media Use:

o  Artist reference (own use, documentation)         

o  Packaging

o  Brochure                                                            

o  Point of sale

o  Catalogue                                                           

o  Poster (less than 10sq metres)                                  

o  Poster (more than 10sq metres)

o  Inserts 

o  Magazine consumer                                      

o  Television/Cinema

o  Magazine trade                                

o  Test

o  National press                                  

o  Other (specify): _______________



o  UK

o  English language areas

o  Single EC Country                                            

o  Worldwide

o  Continental Europe                                        

o  Other (specify): _______________

o  USA


Time Period

One year

Two years

Other (specify): __________________________

Right to a credit asserted: Yes / No


Exclusivity Clause

I confirm that subject to Clause 5 "Terms & Conditions" I shall not publish or supply the material to any other person for publication during the term of the licence plus ________ years, without the express permission of the Agency or the Advertiser.

I confirm that the Agency and the Advertiser are hereby licensed to reproduce and publish the Photographs, for the above purposes, territories and time period, on the terms and conditions set out overleaf.

Under Clause 4 "Terms & Conditions", no use may be made of the Photographs until the invoice has been paid in full.


Signed:                                                                                                                                 Date: