Conflict of Interest disclosure slide for representative speakers or investigators Research fund □contract □donation □public scientific research fund □other （ ） Name of lead presenter Sponsor Institution or company/position No employee of company and/or profit-making organization ※１ □ adviser of company and/or profit-making organization ※２ □ profit of stock ※３ □ lecturer fees ※４ □ manuscript fees ※５ □ donations/contributions ※６ □ research expenses by contract with profit-making organization ※７ □ fees of testimony, judgment, comment, etc. ※８ □ gifts or any other payment ※９ □ Name of principal investigator If yes, please specify the name of company and/or organization, your status. Institution or company/position No employee of company and/or profit-making organization ※１ □ adviser of company and/or profit-making organization ※２ □ profit of stock ※３ □ lecturer fees ※４ □ manuscript fees ※５ □ donations/contributions ※６ □ research expenses by contract with profit-making organization ※７ □ fees of testimony, judgment, comment, etc. ※８ □ gifts or any other payment ※９ □ If yes, please specify the name of company and/or organization, your status. The Japan Lung Cancer Society Conflict of Interest disclosure slide for representative speakers or investigators ( Lead presenter and principal investigator must describe the COI status from January 1st, 2013 to December 31st, which is related to the content of the publication.) ※１ employee of company and/or profit-making organization ― ※２ adviser of company and/or profit-making organization $10,000 or more annual compensation from a single business, entity, or group. ※３ profit of stock $10,000 or more annual dividends, or 5% or more in the applicable business. ※４ lecturer fees $5,000 or more annual income from a single company or organization. ※５ manuscript fees $5,000 or more annual income from a single company or organization. ※６ donations/contributions $20,000 or more annual donations/contributions paid by a single company or organization to you or your department. ※７ research expenses by contract with profit-making organization $20,000 or more total annual research expenses paid by a single company or organization to you or your department. ※８ fees of testimony, judgment, comment, etc. $10,000 or more annual judgment and comment etc, paid by a single company or organization. ※９ gifts or any other payment $500 or more annual gifts from a single company or organization, etc.
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