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

Manuscript Number:  __________________
Manuscript Title:  _____________________________________________________________________________
Author Name:  ________________________________________________________________________________
E-mail:  ______________________________________________________________________________________
Corresponding Author Name (Print):  _____________________________________________________________

In order to publish your paper in the encephalitis, all authors must read and sign the statements on
1. Authorship Responsibility; 2. Authorship Contributions; 3. Role of the Funding Source; 4. Disclosure of Conflicts of Interest; and 5. Copyright Transfer Agreement

1. Authorship Responsibility

• - All authors have seen and approved the content of the submitted manuscript.
• - The paper presents original work not previously published in similar form and not currently under consideration by another Journal.
• - If the paper contains material (data or information in any other form) that is the intellectual property and copyright of any person(s) other than the Author(s), then permission of the copyright owner(s) to publish that material has been obtained, and is clearly identified and acknowledged in the text of the paper.
• - The authors followed ethics guidelines.
• - See the Authorship Policy in Instructions for Authors.

2. Authorship Contributions

Please indicate the specific contributions made by each author (list the authors’ initials, e.g., JKH).

• - Conception and design of study:  ____________________________________________________________
• - Acquisition of data:  ______________________________________________________________________
• - Analysis and/or interpretation of data:  _______________________________________________________
• - Drafting the manuscript:  __________________________________________________________________
• - Critical revision:  _________________________________________________________________________
• - Approval of the final version of the submitted manuscript:  _______________________________________

3. Role of the Funding Source

Please disclose any funding sources and their role, if any, in the writing of the manuscript or the decision to submit it for publication. The information provided here must match the role of the funding source statement in the manuscript.

4. Disclosure of Conflicts of Interest

Please check A or B

• □  A. We/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. We/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.

__________________________________________________________________________________________________
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5. Copyright Transfer Agreement

In the occasion of the final acceptance of this manuscript, the authors of the article hereby agree that encephalitis holds the copyright on all materials and the right to publish, transmit, sell and distribute them in the journal or other media. The authors 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 encephalitis, either in print or online by commercial parties (including publication in other journals or books) prior permission from encephalitis must be acquired.

Corresponding Author

Co-Authors

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