Copyright Return / Grant Request Form (Form B)

Please return a completed form to IPSJ via FAX (+81-3-3518-8375), email (editj [at] ipsj.or.jp), or snail mail

To: Information Processing Society of Japan

Based on IPSJ Copyright Guidelines Article 5, Part 4, I hereby request returning the copyright of my paper below.

Upon the return of the copyright, I grant IPSJ the right to use the paper below that IPSJ or parties designated by IPSJ for the purposes corresponding to items specified in each part of Japanese Copyright Law Articles 21 to 28 (including copying, public transmission, delivery, and translation).

I also notify to any recipients of the copyright that the grant to IPSJ is in effect.

(1) Copyrighted material to be returned.

Publication Name (e.g., IPSJ SIG Technical Report 2000-HPC-82) :

Title :

Length in Pages :

Authors (All the authors must be listed) :

(2) Purpose of Return (Check one)

Submission to a journal of another society (incl. academic publishers) :

Name of the society :

Name of the journal :

Acceptance for publication at a journal other than IPSJ (incl. academic publishers) :

Name of the society :

Name of the journal :

Publishing :

Publisher :

Contact person (name, email, phone, and address) :

Others :

(3) Requester Name (all the co-authors must have agreed on this request)

Date :

Signature :

Affiliation :

Phone :

E-mail :