ࡱ> NPMO *,bjbj((B2JeJe =====QQQ8$DQ.ELS(-------$A13z .Q={EE{{ .==T[.{X==-{-+8-/N,-q.0.(,q4q4(8-q4=8-{{{{{{{ . .${{{.{{{{q4{{{{{{{{{ : To: President of Hiroshima University Written Complaint Form Concerning Misconduct Related to Research Activities 0000000000000000 Complaint Reference No. ____0000 Complainant s Name0Date of ComplaintMonth / Date / Year / / Complainant s AffiliationDetails of the complaints0Information on the staff member who allegedly committed misuse00 00Alleged staff member s name00000000000000Affiliation0000000000000 Details of the misuse of research funds, etc. and the reasonable grounds for the complaint 000(When)000000000000000000000000000000000 000(Where)00000000000000000000000000000000 000(How)000000000000000000000000000000 000000000000000000000000000000000000000 000000000000000000000000000000000000000 0Other %Do you have any evidence? 00a Yes (documents / magnetic tapes / floppy disks / other (0000000000)00 b NoPreferred method of contact and contact information (multiple answers possible)Telephone (Telephone No.: )e-mail (e-mail address: 00000000000000000 000 00)FAX (FAX No.: 0 000000home / office / other (000 00 0 ))Postal mail (Address:00 0000000000000 0000 00)Other preferences (000000000 000000000000 0 0)0 Whenever possibJLNP D F |     2 4 H N P ·}y}}tptpk h+7o(h6 h6o(h~h~u h~uo(h8hph8o( h8>*o(hp hpo(h} h}o( h8o( h.>*CJh8>*CJKHo(h+7>*CJKHh^J>*CJKHh^J>*CJKHo( h&wGCJo( h8CJ h>7CJ hpCJ hpCJo((LN   jskd$$Ifc\o&l( Fl(4 cacyt&wG $$Ifa$$If $$Ifa$gdp$a$  J L N  y & F$Ifgd{4$qq$If]q^qa$gd+7Rkd$$Ifc4F0l( l(4 cacf4yt&wG$If $$Ifa$gd~uP    * : F ` d f z < N P R Z d f     R Z  ¹ۭۭ󤛓hpOJaJhpOJaJo(h8OJaJo( hp>*o( hp>*h{4h{4KH h{4KH h^J>* h^J>*o( h8>*o( h8>*hG%1h~ h{4h{4h{4 h8o(h8h+7:   P R T   R T $If$ & F$Ifa$gd^4$IfRkdQ$$Ifc40Sl(S%l(4 cacf4yt&wG   D $IfWD`Rkd$$Ifc4[ 0Sl( S%l(4 cacf4yt&wG & F 8!$4$5$7$8$G$Ifgdp$If BDJLNVXNRTbd*,.0Nz|"$&(6<@\^hlp&&&8'J't'v''U h}o( h@:h}h}h^Jh8hp hpo( h8o(UYRkd$$Ifc40l( l(4 cacf4yt&wG & F$Ifgd} $Ifgd}<kd$$Ifcl(l(l(4 cacyt&wG  tCRkdF$$Ifc40l(  l(4 cacf4yt&wG & F$Ifgd} $Ifgd}Rkd$$Ifc40l(  l(4 cacf4yt&wGtvxC6 \^`\gd}Rkd$$Ifc4F0l(  l(4 cacf4yt&wG & F$Ifgd} $Ifgd}Rkd$$Ifc40l(  l(4 cacf4yt&wGle, please use your name and provide your preferred method of contact and contact information. It may not be possible to fully investigate the facts if the complaint is made anonymously. Fill in as much information about your complaint as you can. (You do not have to fill in everything.) Evidence includes not only documents, but also electromagnetic recording media and other items that can be used as evidence of the fact of the contents of a complaint. Please submit these items when you report a misuse. The name and other personal information will be used only to the extent necessary for contacting the complainant from the reporting office, etc., and for investigating the case as well as for handling the complaint. The information will be protected appropriately.     v'B() ,,,,,,, ,$,&,(,*,gd} & Fgd}'''(@(B(|))))))***+.+R++++ , ,,,,,,, ,",(,*,h jh U h8o( h~uh} h}o( h@:h}h} @&P 0p1$2P:p&wG. 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