Authorship Responsibility and Contributions, Disclosure of Conflicts of Interest, and Copyright Transfer Agreement

Each author must read and sign the statements on 1. Authorship Responsibility and Contributions; 2. Disclosure of Conflicts of Interest; and 3. Copyright Transfer Agreement. This form is available online at http://submit.e-ultrasonography.org.

Manuscript Number: _____________________________________________________________________________

Manuscript Title: _____________________________________________________________________________

Author Name: _____________________________________________________________________________

E-mail: _____________________________________________________________________________

Corresponding Author Name (Print):_____________________________________________________________________________

1. Authorship Responsibility and Contributions.

Each author must meet all the criteria below (A and B) and must indicate contributions by checking the appropriate boxes.

A. I certify that
□ the manuscript represents original and valid work by the authors and that neither this manuscript nor one with substantially similar content has been published or is being considered for publication elsewhere, except as described in an attachment, and copies of any closely related manuscripts are provided; and
□ the study was conducted under an approval by the Institutional Review Board/Animal Care Committee of the institution where the study took place for any investigation involving humans or animals.

B. Each author must meet the criteria for authorship as established by the International Committee of Medical Journal Editors (ICMJE). As an author, I certify that I have made substantial contributions as described below:

1) (check at least 1 of the 3 below)
□ Conception and design
□ Acquisition of data
□ Analysis and interpretation of data

2) (check at least 1 of the 2 below)
□ Drafting of the manuscript
□ Critical revision of the manuscript for important intellectual content

3) (must be checked)
□ Approval of the final version of the submitted manuscript

2. Disclosure of Conflicts of Interest.

Please check A or B.
□ A. I do not have and have not had a financial interest or other relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest or other financial benefit.
□ B. I now have or have had a financial interest or other relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest or other financial benefit.
Pease list the manufacturers and/or service providers with whom you have a financial relationship, and describe the condition of your relationship. Please be specific.

3. Copyright Transfer Agreement.

I hereby transfer all copyright to Ultrasonography, if the article is accepted for publication in the Ultrasonography. I have understood that all proprietary rights other than the copyright (such as patent rights) are maintained by the authors and that for any reproduction of the material published in Ultrasonography, either in print or online by commercial parties (including publication in other journals or books) prior permission from Ultrasonography must be acquired.

Your Signature ___________________________ Date Signed ___________________________