Registration Document for
Recombinant DNA Experiments
Please type. Attach
additional sheets, if
necessary.
RD Number
Principal Investigator's Name Laboratory Building and Room No.
Organization (Lab/branch name)
ICD Office Phone No. Office Building and Room No.
SECTION A.
Will the experiments be carried out in Escherichia coli or other prokaryotic hosts?
Yes, Escherichia coli
Yes, other prokaryotic hosts No. (Go on to Section B.)
If "yes," describe the specific host, vector, and DNA to be inserted and briefly describe the objectives of the experiment (include references or
appropriate information when necessary).
Relevant section of the NIH Guidelines
Physical containment
SECTION B. Will the experiments be carried out in eukaryotic cells?
Yes No. (Go on to Section C.)
If "yes," describe the specific host, vector, and DNA to be inserted and briefly describe the nature of the experiment (include references or
appropriate information when necessary).
If a viral vector is to be used, will
infectious virus be generated?
Yes No
Relevant section of the NIH Guidelines Physical containment
SECTION C. Will studies include attempts to obtain expression of a foreign gene, other than those used for selection purposes?
Yes No. (Go on to Section D.)
If "yes," what protein?
NIH 2690 (06/13) FRONT
Registration Document for Recombinant DNA Experiments
(Back)
RD Number
SECTION D.
List personnel associated with this experiment in Sections A, B, and C, and have them initial by their names to indicate that they have read
and understand the nature of these experiments. (Use chart below.)
Name of Personnel Initials Name of Personnel Initials
SECTION E. Will animals be used in any aspect of the described experiment(s)?
Yes No. (Go on to Section F.)
Attach the Animal Research Protocol to this document.
List all the species and locations where animals for the described experiments will be housed.
List the names of those personnel involved with the animal studies, including researchers and caretakers.
SECTION F.
I acknowledge my responsibility for the conduct of this research in accordance with Section IV-B-5 of the NIH Guidelines.
Principal Investigator (signature)
Phone No. Building/Room
The laboratory was certified at the BL level of containment
on
The Registration Document was approved by the NIH
Biosafety Committee on
NIH Biosafety Officer Chairman, NIH Biosafety Committee
NIH 2690 (06/13) BACK
