CONTRIBUTION DECLARATION FORM

Paper title:

<insert title of the publication>

Contribution of the authors:

No.	Name, Surname	Affiliation	Contribution to the paper*	Estimated % of the total contribution
<Author’s name and surname>	<Author’s affiliation>	<the appropriate role/roles>	<% value>
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-
-	-	-	-

* Justification of authorship includes 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, 2) drafting the article or revising it critically for important intellectual content, and 3) final approval of the version to be published.

Financial disclosure:

<insert financial disclosure information>

<insert date> Date	………………………………………………… Corresponding Author Signature