LuisenstraÄe Berlin. Spandauer Damm Berlin Robert-Koch-Platz Berlin... Archive Staff Telephone

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For the User Public Corporation Pariser Platz 4 10117 Berlin Robert-Koch-Platz 10 10115 Berlin Luisenstra€e 60 10117 Berlin Chausseestra€e 125 10115 Berlin Spandauer Damm 19 14059 Berlin ...

Archive Staff Telephone

PHOTOCOPY ORDER FORM Invoice/Receipt No. AR

User/Address for Invoice: Will be collected

Please send

I herewith apply for photocopies of the following materials (Collection/System no./Title/Number of Pages):

Authorisation: Date of Production/Invoice: Service Charge ……… ……….. ………..

Post & Packing + …… % VAT Total ………. Date/Signature of User ………€ ………€ ………€ ………

Payable within 30 days  Please write on the bank transfer the invoice no. as stated above, together with the word “Archive”  Berliner Bank BLZ: 100 708 48 ● Account no. 512 706 313 ● SWIFT Code (BIC): DEUT DE DB110 ● IBAN: DE97 100 708 480 5127063 13 The user is responsible for all charges connected with the money transfer. Tax no. 29/033/10720 ● VAT-Identity-Number: DE 220436340

Payment Received in Cash ……….

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For the User Public Corporation Pariser Platz 4 10117 Berlin Robert-Koch-Platz 10 10115 Berlin Luisenstraße 60 10117 Berlin Chausseestraße 125 10115 Berlin Spandauer Damm 19 14059 Berlin ...

Archive Staff Telephone

APPLICATION FOR PERMISSION TO PUBLISH VISUAL MATERIAL Invoice No. AFP

User/Address for Invoice:

I herewith apply with the Archive of the Akademie der K…nste for the permission to publish the following images from its collections (collection/system no.):

Details of Publication:

Independent Publication  Essay  Radio or TV-Program  PhD  Exhibition  Other*

Place of Publication...with... Institution  University  Company  Publishing House Professor

... Estimated Dates of Publication or Deadline Edition/no. of Copies

I herewith confirm that I am aware of the User Regulations of the Archive of the Akademie der K…nste and have read the General Terms of Contract concerning the handling of visual material and am committed to obey the rules therein, most particularly concerning the exact mention of the source and the sending of specimen copies.

Date and Signature of User……….… User Fee……….……… + …… % VAT…….……… Total……….……… Date and Signature of Staff………. Permission for Publication: The Archive of the Akademie der K…nste accords permission – on condition that the User Fee has been paid – for the above mentioned materials to be published. This permission does not release the user from the eventual necessity to pay third party rights.

Date of Invoice / Signature of Head of Department……….

Payable within 30 days  Please write on the bank transfer the invoice no. as stated above, together with the word “Archive”  Berliner Bank BLZ: 100 708 48 ● Account no. 512 706 313 ● SWIFT Code (BIC): DEUT DE DB110 ● IBAN: DE97 100 708 480 5127063 13  The user is responsible for all charges connected with the money transfer  Tax no. 29/033/10720 ● VAT-Identity-Number: DE 220436340

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For the User Public Corporation Pariser Platz 4 10117 Berlin Robert-Koch-Platz 10 10115 Berlin Luisenstra€e 60 10117 Berlin Chausseestra€e 125 10115 Berlin Spandauer Damm 19 14059 Berlin ...

Archive Staff Telephone

PHOTO/SCAN ORDER FORM Invoice / Receipt No. AF

User/Address for Invoice: x Will be collected

x Please send

I herewith apply for the production/loan of a reproduction of the following materials (Collection/System no./Quantity/ Format):

Purpose/Details of Publication:

I recognise the General Terms of Contract. Authorisation: ………. Date/Signature of User ---Production Costs ……….€ ………. Date/Signature of Producer ---Loan Fee

Post & Packing + …… %VAT Total ……….€ ……….€ ……….€ ……….

Payable within 30 days  Please write on the bank transfer the invoice no. as stated above, together with the word “Archive”  Berliner Bank BLZ BLZ: 100 708 48 ● Account no. 512 706 313 ● Swift Code (BIC): DEUT DE DB110 ● IBAN: DE97 100 708 480 5127063 13 The user is responsible for all charges connected with the money transfer. Tax no. 29/033/10720 ● VAT-Identity-Number: DE 220436340

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K‡rperschaft des ‡ffentlichen Rechts Pariser Platz 4 10117 Berlin Robert-Koch-Platz 10 10115 Berlin Luisenstra€e 60 10117 Berlin Chausseestra€e 125 10115 Berlin Spandauer Damm 19 14059 Berlin ...

Archive Staff Telephone

Photo/Scan Order Form

Invoice / Receipt No. ….

User/Address for Invoice: - Will be collected

User/VAT-Identity-Nr.:

- Please send

I herewith apply for the production/loan of a reproduction of the following materials (Collection/System no./Quantity/

Format):

Purpose/Details of Publication:

I recognise the General Terms of Contract. Authorisation: ………. Date/Signature of User ---Production Costs ……….€ ………. Date/Signature of Producer ---Loan Fee

Post & Packing + …… %VAT Total ……….€ ……….€ ……….€ ……….€

Payable within 30 days  Please write on the bank transfer the invoice no. as stated above, together with the word “Archive”  Berliner Bank BLZ 100 708 48  Account no. 512706313 IBAN DE 97 100 708 480 5127063 13  SWIFT Code (BIC): DEUT DE DB110  The user is responsible for all charges connected with the money transfer. Tax no. 29/033/10720. VAT-Identity-Number: DE220436340

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K‡rperschaft des ‡ffentlichen Rechts Pariser Platz 4 10117 Berlin Robert-Koch-Platz 10 10115 Berlin Luisenstra€e 60 10117 Berlin Chausseestra€e 125 10115 Berlin Spandauer Damm 19 14059 Berlin ...

Archive Staff Telephone

Photo/Scan Order Form

Invoice / Receipt No. ….

User/Address for Invoice: Will be collected

User/VAT-Identity-Nr.:

Please send

I herewith apply for the production/loan of a reproduction of the following materials (Collection/System no./Quantity/

Format):

Purpose/Details of Publication:

I recognise the General Terms of Contract. Authorisation: ………. Date/Signature of User ---Production Costs ……….€ ………. Date/Signature of Producer ---Loan Fee

Post & Packing + …… %VAT Total ……….€ ……….€ ……….€ ……….€

Payable within 30 days  Please write on the bank transfer the invoice no. as stated above, together with the word “Archive”  Berliner Bank BLZ 100 708 48  Account no. 512706313  IBAN DE 97 100 708 480 5127063 13  SWIFT Code (BIC): DEUT DE DB110  The user is responsible for all charges connected with the money transfer. Tax no. 29/033/10720. VAT-Identity-Number: DE220436340

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