附表二 Appendix 2 國立中央大學學術著作共同作者貢獻聲明書

National Central University Co-author Contribution Declaration Form

基於學術研究誠信，「著作彙編之學位論文」學生（以下稱聲明人）茲聲明彙編學術著作之相關資訊及共同作者貢獻度。

In the spirit of academic integrity, the undersigned student (hereinafter referred to as "the Declarant") provides the following information regarding the publications compiled in the Thesis by Publication, as well as the contributions of co-authors.
一、聲明人相關資訊

I. Declarant Information

（一）學生姓名： 1. Name:
（二）就讀系所： 2. Department / Graduate Institute:
（三）學位論文名稱：（請自行填入學位論文標題） 3. Thesis Title (please enter full thesis title):

二、彙編著作之相關資訊

II. Publication Details

各篇彙編著作之資訊註 Information on Each Compiled Work Included in a Thesis Chapter Note
彙編著作為內容之論文章節 Chapters and Sections that Include Any Compiled Work
A類型：期刊或研討會之學術著作 Type A: Journal or Conference Publications
期刊或研討會名稱 Journal/Conference Name	（請自行填入期刊名稱或研討會名稱）(Please specify the journal or conference names.)
著作標題 Title of Publication	（請自行填入著作標題）(Please specify the titles of publications.)
出版或發表情況 Publication/Presentation Status	☐已刊登或發表： 年 月 日。 連結網址：https://doi.org/xxxxxxxxxxxxxx Published on (MM/DD/YYYY). DOI or URL: https://doi.org/xxxxxxxxxxxxxx ☐已接受刊登或發表（請附上接受證明）： 年 月 日。 Accepted (proof of acceptance attached), on (MM/DD/YYYY).
卷號及頁碼 Volume and Page Numbers
「著作彙編之學位論文」作者（學生）就此著作之貢獻度聲明 Contribution Declaration of the Author (Student) of the TBP
貢獻說明 Description of Contribution
貢獻程度於整篇學術論文之百分比 Estimated Contribution (% of the total paper)
除聲明人以外之其他共同作者之相關訊息及分工事項 Information on Other Co-authors and Their Respective Contributions
作者排序 （請標明通訊作者） Author Order (Please indicate the corresponding author.)	姓名 Name	著作中登載作者所屬之單位 Affiliation as listed in the publication	分工事項（得加註貢獻度百分比） Specific Contributions (including % if applicable)	是否曾納入下述共同作者的學位論文或教師送審著作 Previously Included in Any Co-author’s Thesis or Any Faculty Member's Submitted Works?
第一作者 First Author
第二作者 Second Author
第三作者 Third Author
B類型：專利 Type B: Patents
專利類型 Patent Type	☐發明專利 Invention ☐新型專利 Utility Model ☐設計專利 Design
專利名稱 Patent Title
創作人 Inventor
專利權人 Assignee
專利期間 Patent Term
C類型：專書(專書篇章) Type C: Books/Book Chapters
專書名稱 Book Title
出 版 社 Publisher
出版日期 Publication Date
「著作彙編之學位論文」作者（學生）就此專書(專書篇章)之貢獻度聲明 Contribution Declaration of the Author (Student) of the Book (Chapter)
貢獻說明 Description of Contribution
貢獻程度於整本或整篇著作之百分比 Estimated Contribution (% of the entire Book/Chapter)
除聲明人以外之其他共同作者之相關訊息及分工事項 Information on Other Co-authors and Their Respective Contributions
作者（若有排序請標記） Author Order (if applicable)	姓名 Name	著作中登載作者所屬之單位 Affiliation as listed in the publication	分工事項（得加註貢獻度百分比） Specific Contributions (including % if applicable)	是否曾納入下述共同作者的學位論文或教師送審著作 Previously Included in Any Co-author’s Thesis or Any Faculty Member's Submitted Works?
註：若您的「著作彙編之學位論文」是由一篇以上著作彙編而成，或共同作者有三位以上者，請依「ABC類型」自行增刪表格填寫，並詳實登錄「論文正文章節」與「各篇彙編著作之資訊」等欄位。 Note: If your TBP includes more than one publication, or if there are more than three co-authors, please duplicate and adjust the tables for each applicable type (A, B, C) as needed. Please clearly match each chapter with the corresponding publication information.

以上聲明均為屬實，如有不實，聲明人願意負相關法律與學術倫理責任。

The above statements are true and accurate. The declarant accepts full legal and academic responsibility for any false or misleading information.

聲明人簽名： Declarant’s Signature:
指導教授簽名： Thesis Advisor's Signature:
共同指導教授簽名（無則免）： Co-advisor’s Signature (if any):
系所單位戳章： Department/Institute Seal:

中 華 民 國 年 月 日

Date:

說明：自114學年度第一學期起，研究生於申請學位考試時，應填寫本表上傳至本校學位考試申請系統；並將本表附於學位論文中研究主軸綜合論述之後。

1141027 Note: Starting from the 2025 Fall Semester (Academic Year 114), graduate students must upload this form to the thesis examination application system when applying for the degree examination. This form must also be included in the thesis immediately following the central research theme.