Plagiarism Declaration Form

Plagiarism Declaration Form Template for Indonesia

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Key Requirements PROMPT example:

"I need a Plagiarism Declaration Form for my university's medical research department that includes provisions for multiple co-authors and handling of sensitive patient data, with specific reference to Indonesian healthcare privacy regulations."

Document background

The Plagiarism Declaration Form is a crucial document in Indonesian academic and professional settings, required whenever original work is submitted for academic credit, publication, or professional use. It aligns with Indonesia's Copyright Law (UU No. 28 Tahun 2014) and academic integrity regulations, particularly those outlined in the Minister of National Education Regulation No. 17 of 2010. The form serves multiple purposes: it protects intellectual property rights, ensures academic integrity, and creates a legally binding record of the declarant's commitment to originality. The document typically includes personal details of the declarant, specific information about the work being declared original, declarations about proper citation and reference use, and acknowledgment of understanding regarding plagiarism and its consequences. It's commonly used in universities, research institutions, and professional organizations across Indonesia.

Suggested Sections

1. Declarant Information: Full name, student/staff ID, institution, department/faculty, and contact details of the person making the declaration

2. Work Details: Title and nature of the work being declared (thesis, dissertation, research paper, etc.), submission date, and course/program details if applicable

3. Declaration of Originality: Primary declaration stating that the work is original, has not been submitted elsewhere, and is the declarant's own work

4. Citation and Reference Acknowledgment: Declaration confirming all sources have been properly cited and referenced according to the required academic standards

5. Understanding of Plagiarism: Confirmation that the declarant understands what constitutes plagiarism and academic misconduct

6. Consequences Acknowledgment: Statement acknowledging understanding of the consequences of false declaration or discovered plagiarism

7. Declaration and Signature: Final declaration statement, date, and space for physical or electronic signature

Optional Sections

1. Co-Author Declaration: Required for works with multiple authors, declaring the extent of individual contribution and confirmation from co-authors

2. Third-Party Copyright Material: Declaration regarding permission obtained for use of third-party copyrighted material, if applicable

3. Confidentiality Statement: Required for works containing confidential or sensitive information, declaring handling and disclosure restrictions

4. Supervisor Confirmation: Section for supervisor's confirmation of originality, typically used for theses and dissertations

5. Previous Publication Declaration: Required if any part of the work has been previously published or presented, including details of such publication

Suggested Schedules

1. Definition of Plagiarism: Detailed explanation of what constitutes plagiarism according to institutional policy

2. Citation Guidelines: Institution's preferred citation style and guidelines for proper academic referencing

3. Penalties and Procedures: Overview of institutional procedures for handling plagiarism cases and potential penalties

4. Academic Integrity Policy: Reference to or excerpt of the institution's complete academic integrity policy

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

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Authors

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