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Form 1-A When giving an oral presentation at a scientific lecture, there is a state of conflict of interest requiring disclosure. The Japanese Society of Gastroenterology (JSGE) COI Disclosure Name of Lead Presenter: ___________________.

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En_coirelease_1-A

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  1. Form 1-AWhen giving an oral presentation at a scientific lecture, there is a state of conflict of interest requiring disclosure The Japanese Society of Gastroenterology (JSGE)COI DisclosureName of Lead Presenter: ___________________ 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: ZZZPharmaceutical Industries (*Indicate "None" if not applicable.)

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