InstitutionalBiosafetyCommittee.docVIP

Institutional Biosafety Committee (IBC) Protocol Application: Research Involving Recombinant or Synthetic Nucleic Acid Molecules PART I. (Complete for All Recombinant/Synthetic Nucleic Acid Experiments) SECTION A: General Information (All text boxes will expand) 1. Investigator name: 2. Contact Information: Office Lab Email 3. Department: 4. Protocol Title: 5. Funding Agency/ Grant / Contract Number (Please attach copy of grant abstract): 6. Proposed start date: Proposed end date: 7. Location of work: Building Room 8. Personnel - list all faculty, students, and staff who will work on this protocol. (Note: All protocol personnel must complete the online training module, “Working with Recombinant DNA Molecules” found at: /ra/real/researchspace.php?view=7training_view=my_training.) SECTION B: Protocol Information 9. Please provide a general description of the experiments to be conducted, including a description of any significant risks if appropriate.  10. Please provide the following information.  Nature/Source(s) of Inserted DNA Sequences: include genus/species, name of protein pathway, etc. Describe the intended use of the rDNA and the function / activity of the DNA or its product. Examples – new protein expression, cloning, transgenic generation, etc. Hosts for propagation: Examples - E. coli K-12, HeLa Cells, Mouse Note: This corresponds to both the production of rDNA and the species into which it will be introduced – include all. Method of Gene Transfer/Vector(s): Examples - plasmid, virus, amplicons or transposons, naked DNA, conjugation, chemical, etc. SECTION C: Exemption Determination 11. The NIH Guidelines provide a description of recombinant/synthetic nucleic acid experiments that are considered exempt. UTA Policy requires registration of Exempt experiments via submission of Part I of this Application. Non-Exempt res