Illinois
Department of Natural ResourcesIllinois Department
of Natural Resources
Image Purchase Request & Terms
This form is to be used to purchase photographs for personal use. The
Commercial Form should be used for all other requests. Images can not
be reproduced or displayed commercially without written permission.
Mail completed form and check payable to:
| Illinois Department of Natural Resources |
| One Natural Resources Way |
| Springfield, Illinois 62702-1271 |
| Attn: Adele Hodde |
(Please Print):
Name_________________________________Address_________________________________
City__________________ State_____Zip_______Phone Number (daytime)_____________
_________________________________________________________
Signature
Date
Photograph appeared in:
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Month/ |
Year/ |
Page
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Year/Month |
| Website image______________________________ |
| Print prices include sales tax: |
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| 5x7 - $8.50 |
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| 8x10- $21.25 |
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| 11x14-$37.19 |
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| Add Shipping & Handling charges: | S&H |
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5x7 or 8x10 prints $5.00 per order |
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Prices are subject to Change |
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For Office
Use only:
Date order received______________ Date ordered shipped________________
IDNR Approval
By__________________________
Revised 07/08