I own and retain all rights in my copyrighted work entitled ________________________ (the “Protected Work”), first published on _______________, ______ and registered on (insert copyright registration date if applicable). It has recently come to my attention that you have made unauthorized use of the Protected Work by (describe how the copyright has been violated, e.g. displaying my work on your website, using the Protected Work as the basis for another work, etc.).
You have neither requested nor received permission from me to use the Protected Work in any way. Therefore, your use of the Protected Work is an infringement of my rights under 17 U.S.C. Section 101 et seq. and you could be liable for statutory damages as high as $150,000 as set forth in Section 504(c)(2) therein.
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