Scan requests

-- I hereby request you to supply me with a copy of the item(s) detailed below or by email which I require for the purpose of research for a non-commercial purpose or private study.
-- I have not previously been supplied with a copy of the same material by you or by any other librarian.
-- I will not use the copy except for private study or research for a non-commercial purpose and will not supply a copy of it to any other person.
-- To the best of my knowledge, no other person with whom I work or study has made, or intends to make at about the same time as this request, a request for substantially the same purposes.
-- I understand that if this declaration is false in any 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 had made it myself.
-- I will retain only a single paper copy and will destroy any electronic copies after printing.