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Republic of the Philippines

TARLAC STATE UNIVERSITY


University Research Office
Tel. No. (045) 606-8190/ E-mail Address: research@tsu.edu.ph

AUTHORS’ DECLARATION CONSENT FORM

This is to authorize _________________________________ to claim and collect the:


Terminal Incentive Citation Incentive
Publication Incentive Reimbursement of Publication Fee
Presentation Incentive
Research Title:

Lead Author: Co- Authors

Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name

Form No.: TSU-URO-SF-49 l Revision No.: 01 I Effective Date: October 4, 2019 I Page 1 of 1

Republic of the Philippines


TARLAC STATE UNIVERSITY
University Research Office
Tel. No. (045) 606-8190/ E-mail Address: research@tsu.edu.ph

AUTHORS’ DECLARATION CONSENT FORM

This is to authorize _________________________________ to claim and collect the:


Terminal Incentive Citation Incentive
Publication Incentive Reimbursement of Publication Fee
Presentation Incentive
Research Title:

Lead Author: Co- Authors

Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name

Form No.: TSU-URO-SF-49 l Revision No. 01 l Effective Date: October 4, 2019 l Page 1 of 1

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