1
Research Output Type
e.g. Book/chapter/journal article/conference
paper.
Title
This can be a holding title for the research
output.
Brief Summary of the Research Described
in the Research Output
This can be in dot points or brief sentences
of main points of the research output and
may change over time.
Submitted/resubmitted for Publication to
(name of journal/publisher/conference,
exhibition )
Anticipated Submission Date
AuthorsNames, ORCID No. and
Signatures
Substantial Contribution
(see criteria in Australian Code for the Responsible Conduct of Research
(2018) if relevant state order of authors if this is applicable to the discipline)
Proposed
order
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Please use the continuation page for additional authors.
Have you used a continuation page? Yes No
Statement of Authorship
Please ensure you are completing the latest version of 'authorship agreements' and refer to the Authorship Guidelines when completing
this form.
Statement of Authorship Agreement V.1 - June 2019 CRICOS Provider No: 00124K (Melbourne), CRICOS Provider No: 02475D (Sydney)
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2
Victoria University Research Project ID codes and
ethics/biosafety identification codes (if relevant)
Ethics/Biosafety Application ID (e.g. HRE19-099, AEC
19-09, and/or IBC19-09) (Include information on
whether the Application has been approved)
Acknowledgements
(Please provide name and signature where possible/appropriate)
Justification
Name:
Signature:
Name:
Signature:
Acknowledgements of funding sources or other external assistance
Please use the continuation page for additional acknowledgements.
Have you used a continuation page? Yes No
Please record the location and a general description of the research data supporting this publication. Further
information on research data storage requirements is available from https://www.vu.edu.au/researchers/research-
lifecycle/manage-share-research-data/research-data-management
Location of Data:
e.g. VU R Drive.
Details (including nature and volume of data and type of media):
Certification of Inclusion:
This form can also be used to record agreement between contributors for the authorship of research outputs. If you are
using this form in this way, clearly print your name and sign to certify your inclusion or exclusion as an author.
Signature:
Statement of Authorship Agreement V.1 - June 2019 CRICOS Provider No: 00124K (Melbourne), CRICOS Provider No: 02475D (Sydney)
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3
Lead/Coordinating Author:
As Lead/Coordinating Author I certify that:
1. The signatures above indicate that those listed are the only authors of the publication, that they will approve the version of
the paper submitted for publication and that the authors will agree with to nomination of lead author, in accord with the
Australian Code of the Responsible Conduct of Research (2018), relevant legislation and VU guidelines and policies.
2. The research has been conducted in accordance with the Australian Code of the Responsible Conduct of Research
(2018), relevant legislation, VU policies and guidelines.
3. The research data has been/will be stored in accordance with the requirements of the Australian Code of the Responsible
Conduct of Research (2018), relevant legislation and VU guidelines and policies.
Name:
Signature:
Date:
Copies of completed authorship statements are to be made available to all authors by the Lead/Coordinating author.
Statement of Authorship Agreement V.1 - June 2019 CRICOS Provider No: 00124K (Melbourne), CRICOS Provider No: 02475D (Sydney)
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Continuation Page: Contributing Authors
Complete this section if the number of contributing authors exceeds the table on page 1
Authors Names and
Signatures
Substantial Contribution
(see criteria in Code if relevant state order of authors if this is applicable to the
discipline)
Proposed order
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Name:
ORCID No:
Signature:
Signed by Lead/Coordinating Author:
Name:
Signature:
Date:
Statement of Authorship Agreement V.1 - June 2019 CRICOS Provider No: 00124K (Melbourne), CRICOS Provider No: 02475D (Sydney)
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Continuation Page: Acknowledgements
Complete this section if the number of acknowledgements exceeds the table on page 2
Acknowledgements
(Please provide name and signature where
possible/appropriate)
Justification
Name:
Signature:
Name:
Signature:
Name:
Signature:
Name:
Signature:
Name:
Signature:
Name:
Signature:
Name:
Signature:
Signed by Lead/Coordinating Author:
Name:
Signature:
Date:
Statement of Authorship Agreement V.1 - June 2019 CRICOS Provider No: 00124K (Melbourne), CRICOS Provider No: 02475D (Sydney)
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