Clinical & Experimental Otorhinolaryngology(CEO)
Manuscript: No.
□Original article □Review article □Editorial
Title :
PLEASE SIGN ALL THREE FORMS
Form 1. Prior Publication Certification
1. This manuscript contains original material. Neither the article nor any part of its essential substance, tables
or figures have been or will be published elsewhere prior to appearing in the CEO.
Printed Name ______Signed:______Date:______
2. Some of the material in this paper has been, or is being published elsewhere. Details are supplied in the
appended letter.
Printed Name ______Signed:______Date:______
Form 2. Assignment of Any and All Copyright
In consideration of the CEO taking action in reviewing and editing my (our) submission, the author(s)
undersigned hereby transfer, assign and otherwise convey all copyright ownership to the CEO in the event
that such work is published by the CEO. In addition to publication of my (our) article in conventional printed
form, my (our) assignment of copyright also signifies my (our) agreement to its publication and/or storage
electronically. The publisher may also arrange to include my article in electronic document-delivery services
and databases.
Must be signed by all Authors:
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Printed Name ______Signed:______Date:______
Form 3. Conflict of Interest Disclosure Statement by an Author of a
Manuscript submitted to the Clinical & Experimental Otorhinolaryngology
I, (We) ______, have submitted for publication in the CEO
a manuscript entitled:
______.
______
I, (We) hereby certify, that to the best of our knowledge (Please circle one) :
1. No financial support or benefits have been received by me or any co-author, by any member of
my (our) immediate family or any individual or entity with whom or with which I (we) have asignificant relationship from any commercial source that is related directly or indirectly to thescientific work reported in the article except as described below.
2. I (we) understand an example of such financial interest would comprise a stock interest in anybusiness entity, which is included in the subject matter of the manuscript or which sells a product
relating to the subject matter of the manuscript: Exceptions:
______
______
If any commercial support or special financial interests are described above, I (we) understand
that the Journal staff will make every effort to keep such information confidential during the
editorial review process. I (we) also understand that if the manuscript is accepted, you will
discuss with me (us) the manner to which such information, is to be communicated to the
reader. I (we) hereby grant permission for any such information, or an appropriate summary to
be published in the Journal with the manuscript if the manuscript is accepted for publication.
The corresponding author has an obligation to making sure any and all co-authors sign and
date in this form.
Name of the Corresponding Author: ______
Signature:______Date:______