I have discussed my paper with my editor _______________________.
I request that in the event of my hypotheses being accepted, no person shall attempt to replicate me.
This order is in effect until it is revoked by me.
Being of sound mind & a superficially scientific disposition, I voluntarily execute this order, and I understand its full import.
(Declarant’s signature) (Date)
(Type or print declarant’s full name)
(Editor’s signature) (Date)
(Type or print editor’s full name)
ATTESTATION OF WITNESSES
The individual who has executed this order appears to be of sound mind, and under no duress, fraud, or undue influence, save that of misunderstanding the processes by which scientific knowledge is advanced.
(Witness signature) (Date)
(Type or print witness’s full name)
This form was prepared pursuant to, and in compliance with, the “Harvard do-not-replicate procedure act”.