AUTHORSHIP CERTIFICATE

This is to generally affirm and certify that [INSERT THE NAME OF THE AUTHOR], who is of
legal age, a resident of [INSERT THE COMPLETE LOCATION ADDRESS], and hereinafter
referred to as the “AUTHOR”, is generally responsible, accountable, and obligated for the
work submitted to [INSERT NAME OF THE COMPANY OR INDIVIDUAL WHO IS THE
RECIPIENT OF THE WORK] as his original and true work.

A. Declaration of the Integrity of Submission:

The undersigned “AUTHOR” declared and certified that the submission of his work and
product, to the best of his knowledge and understanding, was not advertised,
circulated, published, publicized, or written previously by other person, materially or to
substantial extent.

All the intellectual contents including those of proprietary character or non-proprietary

character of the work is the outcome and the product of his ability, creativity and
cognition. Further, the “AUTHOR” also declared that all the aid and assistance
received in preparing the work which is the subject matter of this certificate have been
properly and fully acknowledged.

Much more, all outcome relating thereto is the final result of his own research and
determination.

B. Declaration of Warranties and Representations:

The “AUTHOR” gave his complete and full warranty and has whole honestly
characterized that the work which is the subject matter of this certificate, is entirely
original and was made first hand; that the work has not been modified from any other
intellectual properties such as literary, dramatic or any other material of any kind or
nature which are protected from the moment of creation; that the work does not go
against and violate any intellectual property statutory or common law rights; and lastly,
that the wok does not belong to the public domain in any country in the world where
copyright protection is available.

C. Declaration of Citation:

Significantly, the “AUTHOR” have also cited and has given credit to all sources and
informant from which he has obtained his data and information, ideas, or words that
are used or paraphrased in this document.

Moreover, the “AUTHOR” signified that any effort and contribution made to his work by
colleagues and associates are fully recognized and are solely considered as his
own. All the assistance he received in its preparation is fully acknowledged and
disclosed in the documentation.

Much more, he certified that all sources are properly attributed and cited according to
established standards and norms for professional publication.

D. Declaration of Non-Infringement of Intellectual Properties:

The “AUTHOR” strongly manifested that to the best of his knowledge, his work does
not infringe, conflict, run counter, or violate, upon anyone’s copyrighted work or product,
or upon anyone’s intellectual property. Moreover, he “AUTHOR” certified that the work
which is the subject matter of this certificate, does not infringe, transgress, and go
against any proprietary or non-proprietary rights of any individual or juridical entity.

Furthermore, the “AUTHOR” humbly stated and declared that to the extent that there
has been copyrighted material which here intentionally or unintentionally included
which has exceeded the bounds of general and relative fair dealing and fair usage, he
has meticulously obtained and subsequently received a permission and approval from
the copyright owners to include such data and material in current work.

E. Declaration of Non-Falsification
 The “AUTHOR” with all honesty certified that all information, data and findings in the
work have not been distorted, manipulated, falsified or embellished. This is with due
understanding and appreciation that any false claim, assertion and representation in
respect of the work which is the subject matter of this certificate, and that which was
submitted will lead to disciplinary action by the Management in accordance with the
prescribed rules and regulations, as well as in conformity to the legal regulations. This
is also with an understanding that any false warranty herein will lead to criminal
charges and payment and indemnification of damages.

F. Declaration of Conformity to the processes of the Management

The “AUTHOR” further confirmed and with understanding agreed that the work which
is the subject matter of this certificate may be electronically checked for plagiarism or
infringement through the use of a plagiarism detection software or any other means
for detecting plagiarism and infringement as may be determined by the Management.

Should the Management found out that there has been intentional or unintentional
plagiarism, the “AUTHOR” is bound to respect all their decision, including the
forfeiture of the work which is the subject matter of this certificate.

The “AUTHOR” with full understanding finally set forth his signature to express his
confirmation that all outcome of his work is the result of his original effort, and alI information,
methods, and data have been researched thoroughly and processed truthfully.

Moreover, all data and information have not been manipulated and acted upon.

Certified as true and complete this [INSERT DATE OF CERTIFICATION] at [INSERT PLACE
OF CERTIFICATION.]

SIGNED:
BY:
[INSERT FULL NAME OF THE AUTHOR]
AUTHOR

AGREED TO AND ACCEPTED:

BY:
[INSERT NAME OF OFFICER/CUSTOMER]
[INSERT NAME OF COMPANY]