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Dear [name of infringer]
It has come to my attention that you have made an unauthorized use of my copyrighted
work entitled [name of work] (the "Work") in the preparation of a work derived
therefrom. I have reserved all rights in the Work, which was first published on [date] in
[name of publication][, and I have registered the copyright].
Your work entitled [name of infringing work] and which appears [where infringing work
has appeared] is essentially identical to the Work and clearly used the Work as its basis.
You neither asked for nor received permission to use the Work as the basis for [name of
infringing work] nor to make or distribute copies of it. Therefore, I believe you have
willfully infringed my rights under 17 U.S.C. Section 101 et seq. and could be liable for
statutory damages as high as $150,000 as set forth in Section 504(c)(2) therein.
I demand that you immediately cease the use and distribution of all infringing works
derived from the Work, and all copies, including electronic copies, of same, that you
deliver to me, if applicable, all unused, undistributed copies of same, or destroy such
copies immediately and that you desist from this or any other infringement of my rights
in the future.
If I have not received an affirmative response from you by [date] indicating that you have
fully complied with these requirements, I shall consider taking any and all legal remedies
available to rectify this situation.
Important Notice: This is a sample form for illustrative purposes. This sample may
not be suitable for your particular circumstances and different agreements or legal
arrangements may be necessary depending on your jurisdiction. Therefore, you
should not use this sample, or any part, without the advice of competent legal
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