To: Sagauniversity Reception Desk

ReportingForm

Date

To: SagaUniversity Reception Desk

Address:

Name:

Contactinformation:telephonenumber

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Asdescribedbelow,IwishtocarryoutreportingbasedonArticle10ofthe“RegulationsonthePromotionof Research Integrity at Saga University” (enacted February27,2015)asIconsiderthere to have been misconductor suspect misconduct.

1. The nameoftheresearcherornameof the groupsuspectedofthemisconduct(name,affiliation,jobtitle,etc.)

2. The form of the alleged misconductandthedetailsoftherelevantmatter,etc.

(1)Thetypeof alleged misconduct(forgery,falsification,plagiarism,orothermisconduct)

(2)Thedetailsofthe alleged misconduct

(3)Thetime(monthdate, year)andplacethatthe alleged misconductoccurred

3. Ascientificandrationalreason for why it should be deemedmisconduct(evidencematerials,etc.)

4. Relatedpublicfunds,etc.(nameofthe allocation organization,nameofthefund,title,number,etc.)

5. Other relevantinformation

*Importantpoints for completingtheform

1Reportingmaybecarriedoutinwriting; bytelephone, fax, or e-mail; orinperson.

2Inprinciple, the reportershallbe required to provide his/her name whenreporting.

Anonymousreportingshallonlybeacceptedwhenthere are reasonablegrounds,evidence,etc.,tojudge that the relevantreporting is reliable.

3Reportingmustpresentthefollowingitems.

(1)Nameofthe researcher(s) orthenameofthegroupwhom youconsidertohave carried out the misconduct

(2)The form ofthe alleged misconductandthedetailsoftherelevantmatter,etc.

(3) Ascientificandrationalreason for why it should be deemedmisconduct

4Thereportermayberequestedtocooperateintheinvestigation.

5If the investigation finds that the reportingwasmaliciousreporting(note),thereporter’snamemaybepublished, disciplinaryaction taken, and criminalproceedings initiated.

(Note) Maliciousreporting:Reportingsolelywiththeobjectiveofcausingharmtothepersonbeingreportedonorcausingdisadvantagetotheinstitutionororganizationthat he/she belongs tobyentrapping him/her/it orinterferingwith the person’s research, etc.