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  1. Please supply me with a copy of:
    • the item specified on this request which I require for the purposes of research or private study.
  2. I declare that:
    1. I have not previously been supplied with a copy of the same material by you or any other librarian;
    2. I will not use the copy except for research for a non-commercial purpose or private study and will not supply a copy of it to any other person; and
    3. To the best of my knowledge no other person with whom I work or study has made or intends to make, at or about the same time as this request, a request for substantially the same material for substantially the same purpose.
    4. If this item was delivered by an electronic method (which includes facsimile transmission), I will retain only a single paper copy and destroy any electronic copies after printing.
  3. I understand that if the declaration is false in a material particular, the copy supplied to me by you will be an infringing copy and that I shall be liable for infringement of copyright as if I have made the copy myself.
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