Legal Vetting Form Name * First Name Last Name Email * Book Title * Brief Synopsis * List the names of any people of whom name you've changed. Also note any who are no longer living. * Approximate Word Count * This is for purposes of providing an accurate fee quote List any brand names included in the manuscript that you are aware of * Have you copied any text from another source that has not been cited? * Yes No If yes, please describe. Do you own rights to any and all images contained in the manuscript and/or on the cover? * Yes No Not sure If no, please designate which image(s) Is there a nondisclosure agreement or confidentiality agreement in effect that would pertain to any content in this book? * Yes No Not sure If yes, please explain. Describe any particular areas of concern you have. For example, is there a particular person(s) you have concern with suing you? By what means do you plan to publish? * Self-publish Hybrid publisher Traditional publisher Not sure Do you verify that you have answered the above questions honestly and to the best of your ability? * Yes No Signature * /s/ Name Thank you!
