1. 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.

2. 18th WCBIP/WCBE COI Disclosure Name : __________________
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
3. Patent royalties: RRR Pharmaceutical Industries
4. Honoraria: SSS Pharmaceuticals, TTT Pharma
5. Writing fees: UUU Pharmaceutical Industries
6. Grants for commissioned/joint research: VVV Pharmaceuticals
7. Scholarship grants: XXX Pharmaceuticals
8. Endowed chair: YYY Pharmaceuticals
9. Gifts or other forms of compensation: ZZZ Pharmaceutical Industries