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18th WCBIP/WCBE COI Disclosure Name of Lead Presenter: __________________

Form1 （ Example : If there is NO state of conflict of interest requiring disclosure ）. 18th WCBIP/WCBE COI Disclosure Name of Lead Presenter: __________________. There are no companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation.

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18th WCBIP/WCBE COI Disclosure Name of Lead Presenter: __________________

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  1. Form1 （Example : If there is NO state of conflict of interest requiring disclosure） 18thWCBIP/WCBE COI Disclosure Name of Lead Presenter: __________________ There are no companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation.

  2. Form2(Example: If there is a state of conflict of interest requiring disclosure) 18th WCBIP/WCBE COI Disclosure Name : __________________ Companies, etc. in a relation of conflict of interest requiring disclosure in relation to the presentation: 1. Advisor: PPP Pharmaceutical Industries (*Indicate "None" if not applicable.) 2. Stock ownership/capital gain: QQQ Pharmaceuticals (*Indicate "None" if not applicable.) 3. Patent royalties: RRR Pharmaceutical Industries (*Indicate "None" if not applicable.) 4. Honoraria: SSS Pharmaceuticals, TTT Pharma (*Indicate "None" if not applicable.) 5. Writing fees: UUU Pharmaceutical Industries (*Indicate "None" if not applicable.) 6. Grants for commissioned/joint research: VVV Pharmaceuticals (*Indicate "None" if not applicable.) 7. Scholarship grants: XXX Pharmaceuticals (*Indicate "None" if not applicable.) 8. Endowed chair: YYY Pharmaceuticals (*Indicate "None" if not applicable.) 9. Gifts or other forms of compensation: ZZZ Pharmaceutical Industries (*Indicate "None" if not applicable.)

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