From Gigantic Wiki
This template will mark file as being copyrighted, but the copyright holder has given permission for its use. It also will add file to Category:Files uploaded with permission.
Template uses Extension:TemplateStyles; for styles see Template:License/styles.css.
In case the file is already uploaded, type {{permission}} on file information page.
In file upload page choosing "Author/copyright holder gave me permission to use it" option from licensing dropdown will insert template automatically.