Authorship Certificate

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Authorship Certificate

This certificate is issued on this {{day}} day of {{month}}, {{year}}.

Declaration of Originality

I, {{author_name}}, residing at {{author_address}}, hereby solemnly declare that the work titled '{{work_title}}' (hereinafter referred to as 'the Work') is my original creation and has not been previously published in any form, in whole or in part, except as explicitly stated herein. I confirm that the Work does not infringe upon any existing copyright or intellectual property rights of any third party.

Author's Contributions

I further declare that my contributions to the Work are substantial and that I have made significant intellectual contributions to its conception, design, execution, and interpretation. All sources of information and materials used in the creation of the Work have been appropriately cited and acknowledged.

Co-Authors (if applicable)

If the Work has co-authors, their names and affiliations are listed below, and I confirm that all co-authors have reviewed and approved the final version of the Work and agree to its submission for {{purpose_of_submission}}:

1. {{co_author_1_name}}, {{co_author_1_affiliation}}

2. {{co_author_2_name}}, {{co_author_2_affiliation}}

Should there be more co-authors, please list them in a similar format.

Grant of Rights and Indemnification

I understand that by signing this certificate, I am granting {{recipient_name_or_organization}} the right to {{rights_granted_e_g_publish_distribute_license}} the Work in accordance with the terms and conditions outlined in our separate agreement dated {{agreement_date}}. I further agree to indemnify and hold harmless {{recipient_name_or_organization}} from any claims, damages, or expenses arising from any breach of this declaration, including but not limited to claims of copyright infringement or plagiarism.

Conflict of Interest Statement

I declare that I have no actual or potential conflict of interest in relation to the Work or its submission, except for those explicitly disclosed in a separate document provided to {{recipient_name_or_organization}}.

Undertaking

I undertake to inform {{recipient_name_or_organization}} immediately if I become aware of any information that might alter the declarations made in this certificate.

Signature Block

_____________________________

{{author_name}}

Date: {{date}}

Identity Document: {{id_type}}

ID Number: {{id_number}}