Conflict of Interest Self-Reporting Systemfor cooperation with external organizations and communities(2024 Implementation Guidelines)

June 2024
Conflict of Interest Management Committee

To: Faculty and staff
Koumei Matsumura Chair
Conflict of Interest Management Committee

Conflict of Interest Self-Reporting System for 2024Cooperation with externalorganizations and communities (Implementation Guidelines)
As the University advances its cooperation with external organizations and communities, it faces
every day the possibility of conflicts of interest arising from such activities. Respecting faculty and staff
members voluntary activity maximally and rather than treating conflicts of interest as inherently
negative, the Conflict of Interest Management Committee manages conflicts of interest with the aim ofprotecting faculty and staff from troubles by preventing from damages or suspicions in society
concerning such conflicts and keeping their impacts to a minimum, as well as ensuring appropriate
accountability and disclosure in the event they do arise.
Now, the Commitee introduces the status check of conflict of interest for the 2024academic year,
which have been conducted regulary since the 2014 academic year. This is an opportunity for individual
members of faculty and staff to check themselves on the status of conflicts of interest related tocooperation with external organizations and communities. We believe that by answering the questionsin this document you will be able to appreciate the status of any conflicts of interest involving yourself.
At the same time, we intend to manage the status of conflicts of interest in the university by having
faculty and staff submit the results of the questionnaire to us. The cooperation of faculty and staff isappreciated.
Please note that the answers provided and results of totaling responses will be used only for
purposes of management of conflicts of interest.
1. Purpose
To manage conflicts of interest appropriately (e.g., preventing problems, minimizing impacts,and ensuring appropriate accountability and disclosure) through developing a system under which
faculty and staff members inspect the status of conflicts of interest（＊） related to their own
cooperation with external organizations and communities and report to the university any mattersthat should be managed by the university.
（＊）The possibility of loss of judgment (i.e., loss of objectivity) in research, education, contracting, purchasing,or other activities or in business decisions resulting from personal interests or responsibilities in cooperation
with external organizations and communities

2. Eligible persons
Professors, associate professors, instructors, counselors, chaplains, senior specially appointed
professors, project professors, project associate professors, assistant professors, education
instructors, laboratory technicians, PDs, specialist advisers, education and research coordinators,
full-time contracted staff, full-time staff, full-time doctor
Notes: Complete for all cooperation with external organizations and communities in which you are involved, whether
conducted by the University or by you as an individual.
:Even if you do not take part in any cooperation with external organizations and communities, you must indicatethat fact in your responses.

3. Period
Covers cooperation with external organizations and communities during the 2023 academic year
(April 1, 2023

- March 31, 2024)2

4. Activities and overview(1) Check of status of conflicts of interest: Answer the questions on the Check Sheet and then, depending on
the results, advance to step (2), “Submit self-report.”(2) Submit self-report: Submit your self-report to the Committee and then, depending on the content of
the report, advance to step (3), “Interview.”(3) Interview: Conducted as deemed necessary by the Committee
The following cases in research, education,
contracts, purchasing, etc. resulting frompersonal interest or responsibility incooperation with external organizations andcommunities:

Levels of self-reporting
systemLevels of conflict ofinterest

Problem
involving conflictof interest

Appearance of loss of
judgment

Appearance ofproblem involving
conflict of interest

Determined based on the content ofcooperation with externalorganizations and communities, theextent of personal interest or
responsibility, and their actual impact

Submittal of self-report<Certain Standard>(Confirmed through Check 2)

Possibility of loss of
judgment

Possibility of problem involving
conflict of interest

No possibility of loss of
judgment (not involved incooperation with externalorganizations andcommunities)

No conflict of interest

Interviews
Depending on content of selfreport

Answered "Yes" to Check 1,
answered "Yes" to any item
under Check 2

Checking status of conflict ofinterest
Answered "Yes" to 1,
answered "No" to all items
under 2

Answered "No" to 1

Flow of self-reporting system

Loss of judgment

5. Deadlines(1) Check of status of conflicts of interest: Tuesday, July 9 , 2024
(2) Submit self-report: Tuesday, July 9 , 2024
(3) Interview: As necessary, you will be notified by the Committee of the time of the interview
6. Handling of data
Data and information used in the self-reporting system, such as answers to Check Sheets,
self-reports, and records of interviews, will be used for purposes such as Committee deliberations
and other activities and inspections. The data and information will be managed strictly by theCommittee Secretariat pursuant to the document handling rules of the Rikkyo Schools Main Officeand Rikkyo University, under the responsibility of the Chair of the Committee. The Chair of theCommittee shall determine whether to release any data or other information in response torequests for such release. However, in principle any information released shall be released only inthe form of results of statistical inspection, and personal data or similar information shall not bereleased.
7. Inquiries【Committee Secretariat】: E-mail coi@rikkyo.ac.jp＜Sections responsible＞:
Center for Research Initiatives (second floor, Building No. 12), ext.: 4674
Personnel, Division of Personnel (first floor, office Building Annex), ext.: 2245
Notes: See the Conflict of Interest Status Check Implementation Guidelines and the Self-Reporting
Guidelines for procedures on checking the status of conflicts of interest and submitting self-reports.
:See the URL below for information concerning the University’s conflict of interest management system:
http://www.rikkyo.ac.jp/research/initiative/coi/3Conflict of Interest Status Check Implementation Guidelines
The conflict of interest status check is conducted via the Web (using Google Form). Contact the Committee
Secretariat if you would prefer to conduct the check in paper format.
i Click on the URL of the conflict of interest status check.

https://forms.gle/vq2JfKj6bbAreCBP8ⅱLog in. (Log in using your V-Campus ID.)
ⅲConduct the check by answering the questions on each page. The check will be complete after you haveconfirmed the diagnostic results and submitted the record of your answers.
(Refer to the “Steps from Logging In through Submitting Answers” and “Details of Each Page” below.)【Steps from Logging In through Submitting】
Start screen/《a1》 Job title

1． Check of attributes《a1》 Provide your job title.

《a2》 Affiliation《a2》 Provide your affiliation.
《a3,a4》 Provide your name, Rikkyo ID number.

《a3,a4》 Name，Rikkyo ID number

2． Check of status of conflicts of interest《b1》Cooperation with externalorganizations and communities status《b1》 Check 1
Provide answers concerning your cooperation with externalorganizations and communities status during the 2023 academic

Not involved

Involved or not sureyear.(See below concerning cooperation with external organizations
and communities subject to conflict of interest management.)《 b2 》 Economic interests related tocooperation with external organizations and《b2》 Check 2
Provide answers concerning any economic interests related toLess than base level

cooperation with external organizations and communities.

Base level orabove

3． Diagnosis results《c1》 Diagnosis A: Not involved in cooperation with external organizations andcommunities《c2》 Diagnosis B: Involved in cooperation with external organizations and《c1》
Diagnosis A《c2》
Diagnosis B《c3》
Diagnosis Ccommunities but receiving economic interests in connection with suchactivities at less than the base level《c1-3》 Click on the “Submit” button at thebottom of the page《c3》 Diagnosis C: Involved in cooperation with external organizations andcommunities and receiving economic interests in connection with suchactivities at or above the base level

4． Completion《d》 Complete《d》 The check is complete when the message “A record of(Submit a self-report if you received Diagnosis C)

your answers has been submitted” appears.

Cooperation with external organizations and communities Subject to Conflict of Interest Management＜Cooperation with external organizations and communities conducted by the＜Cooperation with external organizations and communities

University＞

conducted as an individual＞

・ Acceptance of endowments*1

・ Serving as a committee member or in other positions

・・ Academic guidance (consulting)*1

Acceptance of research grants-in-aid*1

・ Joint research, subcontracted research, subcontracted operations, or・ Licensing or transfer of rights to intellectual property

academic guidance activities based on contractual agreements*1

・ Serving in concurrent positions*2

・ Licensing or transfer of rights to intellectual property

・ Ownership of stock shares*3

・ Acceptance of researchers and others

・ Activities similar to cooperation with external・ Endowed courses

organizations and communities4*1 Not including acceptance or provision of scientific research expenses related to domestic or foreign public agencies (i.e., governments,
independent administrative agencies, semi-governmental corporations, or other government-related agencies, local government
agencies, and related agencies)*2 Not including concurrent instructor positions*3 Ownership of non-publicly traded shares or publicly traded shares held for other than asset-management purposes (5% or more ofshares issued and outstanding)【Details of Each Page】

1. Check of attributes

Page

Content

Choicesa1

Q1: Provide your job title.

a2

Q2: Provide your affiliation.

Professor, associate professor, instructor, counselor, chaplain, senior speciallyappointed professor, project professor, project associate professor, assistantprofessor, education instructor, laboratory technician, PD, specialist adviser,
education and research coordinator, full-time contracted staff, full-time
staff,full-time doctor
College of Arts, College of Economics, College of Science, College of Sociology,
College of Law and Politics, College of Tourism, College of Community and
Human Services, College of Business, College of Contemporary Psychology,
College of Intercultural Communication, College of Sport and Wellness,
Graduate School of Business Administration, Graduate School of Social Design
Studies, Graduate School of Christian Studies, Graduate School of Artificial
Intelligence and Science, Center for Foreign Language Education andResearch ,Other

2. Check of status of conflicts of interest

a3,a4

Q3: Provide your name, numberof faculty and staff

Page

Content

b1

Check 1: Cooperation with external organizations and communities status during the 2023 academic year
Q1: During the 2023 academic year (April 1, 2023-March 31, 2024), did you take part in any
Yes
cooperation with external organizations and communities subject to conflict of interestNomanagement?
Not sure
Note: If you are not sure whether an activity qualifies as a cooperation with external organizations andcommunities, choose “Not sure.”b2

Check 2: Economic interests related to cooperation with external organizations and communities

Choices

Note: If you answered “Not sure “ under Check 1, answer the following questions on the assumption that the activity
qualifies as a cooperation with external organizations and communities.

Q1: Have you or a family member (spouse or first-degree relative living on the same livelihood) everowned, or do you or the family member now own, non-publicly traded stock in a company
related to cooperation with external organizations and communities?

Yes
No

Q2: Have you or a family member (spouse or first-degree relative living on the same livelihood) everYesNo

owned, or do you or the family member now own, 5% or more of publicly traded stock in acompany related to cooperation with external organizations and communities? (Answer forthe total holdings of you and your family members.)
Q3: Have you or a family member (spouse or first-degree relative living on the same livelihood) everowned, or do you or the family member now own, stock options of a company related tocooperation with external organizations and communities?

Yes
No

Q4: Have you or a family member (spouse or first-degree relative living on the same livelihood) everreceived, or do you or the family member plan to receive in the future, provision of any loan,
guarantee, goods, services, etc. from a company (or corporation, organization, or individual)
related to cooperation with external organizations and communities?

Yes
No

Q5: Have you or a family member (spouse or first-degree relative living on the same livelihood) everYes

5

received, or do you or the family member expect to receive in the future, remuneration or
research grants-in-aid, or donations totaling 1 million yen or more per year from any single
company (or corporation, organization, or individual) related to cooperation with externalorganizations and communities? (Answer for the total amount for you and your family
members.)
Q6: How many of the questions Q1-Q5 of Check 2 did you answer “Yes”?

No

None
1-5

3. Diagnosis results

Page

Contentc1

Diagnosis A: Not involved in cooperation with external organizations and communities subject to conflict ofinterest management
You do not need to submit a self-report at this time.
Diagnosis B: Involved in cooperation with external organizations and communities subject to conflict of interest
management but receiving economic interests in connection with such activities at less than the baselevel
Although you do not need to submit a self-report at this time, you may submit a voluntary self-report.
Diagnosis C: Involved in cooperation with external organizations and communities subject to conflict of interest
management and receiving economic interests in connection with such activities at or above the baselevel
Please submit a self-report. Fill out the necessary information on the designated form and submit it to the Conflictof Interest Management Committee.

c2

c3

Page
4. CompletiondContent《Completion page》 Your answers have been recorded. Thank you for your cooperation.
If you received Diagnosis C, please submit a self-report.

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Self-Report Submittal Guidelines
Fill out the required information on the Microsoft Word form and submit it to theCommittee. i Download the form and fill out the required information.
https://www.rikkyo.ac.jp/research/initiative/aid/interior/papers/asset/15-5_240620.doc
ii Submit the report as an email attachment (coi@rikkyo.ac.jp).

Date (Y/M/D)://

To: Chair, Conflict of Interest Management Committee, Rikkyo University(Affiliation)(Title)(Name)(Email)Self-Report on Conflict ofInterest
I. Period subject to report
April 1, 2022 - March 31, 2023
II. Content of cooperation with external organizations and communities
1. Name of company,
Official name:organization, etc.
(Submit one self-report for□ Also involved in cooperation with external organizations andeach company,

communities with companies, organizations, etc. other than the aboveorganization, etc.)

2. Type of cooperation
with externalorganizations andcommunities＜Cooperation with external organizations and communities conducted by the
University＞□ Acceptance of endowments*1□ Acceptance of research grants-in-aid*1□ Joint research, subcontracted research, subcontracted operations, oracademic guidance activities based on contractual agreements*1□ Licensing or transfer of rights to intellectual property□ Acceptance of researchers and others□ Endowed courses＜Cooperation with external organizations and communities conducted as anindividual＞□ Serving as a committee member or in other positions□ Academic guidance (consulting)*1□ Licensing or transfer of rights to intellectual property□ Serving in concurrent positions*2□ Ownership of stock shares*3□ Activities similar to cooperation with external organizations andcommunities*1 Not including acceptance or provision of scientific research expenses related todomestic or foreign public agencies (i.e., governments, independent administrati
ve agencies, semi-governmental corporations, or other government-related agencies, local government agencies, and related agencies)*2 Not including concurrent instructor positions*3 Ownership of non-publicly traded shares or publicly traded shares held for other than asset-management purposes (5% or more of shares issued and outstanding)

73. Content and time ofactivity(Content of activity)(Time of activity*)*Enter the total amount of time involved in the applicable cooperation with externalorganizations and communities (including the time spent on preparations).

4. Impact of the above
activityIs there a possibility that this activity could hinder activities in the university?
□

Yes (details:) □ NoIII. Details of conflict of interest related to cooperation with external organizations and communities(Instructions)・Check the items that apply below and enter the details in the parentheses.
・If you have multiple interests, enter all of them below, even if they do not exceed the individual base levels.
・If you receive a Ministry of Health, Labour and Welfare grant-in-aid for scientific research, you must submit
the separate Application.
Including spouse or first-degree relative living on the same livelihood□ Ownership of non-publicly traded stock:
1. Stock shares
Shares: （shares）; percentage: （％）
4□ Ownership of publicly traded stock* :Shares: （shares）; percentage: （％）*4 Report if you own 5% or more of shares issued and outstanding□ Ownership of stock options:□ Sale of stock*5:

Shares: （Shares: （shares）; percentage: （shares）; sale price: （

％）

yen）

* 5 Report if you sold non-publicly traded stock or stock for which you owned 5% ormore of shares issued and outstanding ,during the period subject to report.

□ Not applicable
2. Income□ Royalty income;amount: (yen);

details:（）(Report if the amount received
from a single company or□ Lecture fees, manuscript fees;amount: (□ Endowments;

yen);

yen);

details:（）

organization totals 1 million yen
or more per year.)amount: (□ Research grants-in-aid;

amount: (details:（yen);□ Dividends;

amount: (yen)□ Other (salary etc.);

amount: (

yen);

）

details:（）

details:（）□ Not applicable
3. Benefits (loans, goods,
etc.)□ Receipt of loan;

amount: (□ Receipt of guarantee;yen)amount: (details:（）yen) details:（）□ Receipt of goods or use of facilities free of charge;
equivalent amount:（yen） details: （）□ Receipt of services free of charge;
equivalent amount: （yen）details: （）□ Other;

details: （□ Not applicable8）

Not including spouse or other relatives
4. Other□ University contracting to purchase goods or services from a company,
details: （）
organization, etc.
□ Lending students to a company, organization, etc. details:（）□ Serving in an official position with a company, organization, etc.
details: （）□ Other (ex.: provision of on-campus facilities)
Details: （）

IV. Other matters on which you would like to request deliberation, advice, a meeting, etc. regarding
conflicts of interest

The gathered personal information is used for purposes such as COI Management Committee deliberations and other activities.

9Conflict of Interest Management Committee, Rikkyo University【Secretariat】 email:coi@rikkyo.ac.jp

Research Initiative Center, Rikkyo University (second floor, Building No. 12)
Tel.: 03-3985-4674
Human Resources Office, Human Resources Division, Rikkyo University(first floor, Office Building Annex)
Tel.: 03-3985-2245

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