RESEARCH AUTHOR’S SELF DECLARATION FORM (RASDECL)

/
Candidates must submit this form to ASHA’s Research and Development wing, along with ‘Co-author authorisation’ forms completed by each co-author with the required copies of their paper and Submission of Paper form. If you are including multiple publications in your paper you will need to complete a separate form for each publication. Further information on this policy is available at:

A. Publication details (to be completed by the candidate)

Full title
Authors
Authors Contact Details
Candidate’s contribution (%)
Journal or book name
Volume/page numbers
Status / Acceptedand In pressPublished / Date accepted/ published

B. CANDIDATE’S DECLARATION

1 / Material submitted for Publication/Award
(a) / I declare I am the sole author of this paper.
(b) / I declare all verbatim extracts contained in the paper have been identified as such and sources of information specifically acknowledged.
(c) / I certify that, where necessary, I have obtained permission from the owners of third party copyrighted material to include this material in my paper and make it available on web pages.No results of other researchers were used in the submitted manuscript without their consent, proper citation or acknowledgement of their cooperation or material provided.
(e) / either / *I declare that no material the results (or any part of them) contained in the paper has been used in any other submission for publishing or an academic award nor have they already been published (or if so, that the relevant works are cited in this manuscript).
or / *I declare that the following material contained in the paper formed part of a submission for the award of ………………………………………………………… (state the award and awarding body and list the material below):
(f) / I agree that an electronic copy of the paper be held in the ASHA Research Wing Open Access Institutional Repository with full public access, that a paper copy (if available) be held in the library, and that ASHA supplies the copy of the paper in paper or electronic format for further distribution and inclusion in a central electronic repository with full public access, with the following status:
either / *Release the entire paper immediately for access worldwide
or / *Restrict access to the paper after the date of deposit of the paper.
If restricting access, please indicate below the reason for this (delete as appropriate):
* The release of the material would prejudice substantially the commercial interests of any person.
OR
* The material includes information that was obtained under a promise of confidentiality.
* Other. Please specify the reason for exemption.
The corresponding author, on behalf of all co-authors, declare that
  • The authors were all actively involved in obtaining the results
  • The authors are acquainted with the manuscript
  • The authors agree to its publication after any amendments arising from the peer review
  • The authors agree to the posting of the full text of this work on the web page of the journal and to the inclusions of references in databases available on the internet
  • Submission of the manuscript for publication was completed in accordance with the publishing regulations pertaining to their workplace
  • The candidate/s contributed greater than 50% of the content in the publication and is the “primary/Secondary author”, i.e. the candidate was responsible primarily for the planning, execution and preparation of the work for publication
  • It has been peer-reviewed and accepted for publication
  • The candidate has approval to include the publication in their paper from their Respective Advisory Committee/s.
  • It is a primary publication that reports on original research conducted by the candidate during their enrolment
  • The initial draft of the work was written by the candidate and any subsequent editing in response to co-authors and editors reviews was performed by the candidate
  • The publication is not subject to any obligations or contractual agreements with a third party that would constrain its inclusion in any publication/s.
  • Experiments performed comply with current laws and the written consent of the Respective Committee / Authorities.
I declare that the publication above meets the requirements to be included in the paper. The authors agree ASHA Research and Development Department will be the copyright owner after publication of the paper.
I hereby grant to ASHA the non-exclusive right to archive and make accessible my paper, in whole or in part in all forms of media. I agree that, for purposes of preservation, file format migration may be carried out, should this be necessary.
I retain the ownership rights to the copyright of my work. I retain the right to use all or part of this paper in future works (such as books and articles).
Candidate’s name / Candidate’s signature / Date (dd/mm/yy)
Name of Principal Subject Supervisor / Signature of Principal Subject Supervisor / Date (dd/mm/yy)
C. PRINCIPAL SUPERVISOR’S declaration
I declare that:
  • The information above is accurate
  • The advisory committee has met and agreed to the inclusion of this publication in the candidate’s paper
  • All of the co-authors of the publication have reviewed the above information and have agreed to its veracity
  • ‘Co-Author Authorisation’ forms for each co-author are attached.

Supervisor’s name / Supervisor’s signature / Date(dd/mm/yy)
D. This section of the form is for internal use only, for completion by the convener of the research wing/ committee
I declare that:
  • The information provide above is satisfactory.
  • The advisory committee has met and agreed to the inclusion of this publication in the publication.
  • All of the co-authors of the publication have reviewed the above information and have agreed to its veracity.
  • ‘Co-Author Authorisation’ forms for each co-author are attached.

Date considered by the ASHA Board:
Approved
Rejected
Reason for decision
Signed
Authority’s name / Authority’s signature / Date(dd/mm/yy)