s t o c k• u s a g e• f o r m step 1 of 3
company/billing information
1
Your name
2
Title
3
Company Name
4
Street
5
City
State Zip Code
Country USA Other
6
Day Phone
7
 Fax
8
Email
9
•
Job #
Agreed fee (or if you consulted the pricing menu), indicate fee below
Usage/License Fee $
usage specs
12
Total # of
photos requested
13
Photo ID numbers
14
Photo descriptions
15
Usage type
 Advertising Corporate Editorial Nonprofit
16
End user's name
(your client)
17
End Product
Annual Report Brochure Magazine Newsletter Sales Aid
Textbook Book Billboard Poster Packaging TV
Other
18
Publication (or
presentation) title
ISBN #
19
Main head copy
20
Publication date
21
Press run
or circulation

if more than one publication, please itemize each separately
22
Publication size
in Inches
if not applicable, write "0"
23
Ad size in inches
24
Image Size
in Inches
please provide accurate image dimensions / if slide/video, enter "video"
25
Image size
relative to page
 1/4 1/2 3/4 full page Double Page Video
please note: if size indicated will not match your finished printed
sample, an invoice will be issued for the price difference.
26
Placement
 Inside Chapt. Opener Cover Inside Cover Back Cover
Other
If more than one publication, please itemize each separately in "other"
27
Distribution
 National Regional Local In-house
Specify Area
28
 Electronic Rights None
Yes:
Duration
Other
29
Exclusivity
Non-exclusive Exclusive Other
30
Period of License
One-Time 3 months 6 months 12 months
Other
Usage period begins (d/m/y) Ends (d/m/y)
31
How many times
will the Ad repeat?
Explain
32
Usage rights area
North American English Language Only International
Other
33
 Languages
34
Can client provide
photo credit?
 Yes No
comments, questions, or other information
35
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