Form NIFA-2008 Assurance Statement(s)

CRIS - Enter/Edit CSREES-2008

Enter information for CSREES-2008 Assurance Statements
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OMB Approved 0524-0039

STATEMENT OF POLICY ... read this if you are unfamiliar with the purpose of this form
2. Project number
TEST-123

1. Institution
TEST - test this process

3. Project director
Smith, C. C.

4. Title of project:
Title Here
Check appropriate statements, supplying additional information when necessary.
A. BIOSAFETY OF RECOMBINANT DNA
Project does not involve recombinant DNA.
Project involves recombinant DNA and was either
approved
determined to be exempt from NIH Guidelines by an Institutional Biosafety Committee
on:

(Date as mm/dd/yyyy)

This performing organization agrees to assume primary responsibility for complying with both the intent and procedures of the National
Institutes of Health's (NIH), DHHS Guidelines for Research Involving Recombinant DNA Molecules as revised.
B. CARE AND USE OF ANIMALS
Project does not involve use of vertebrate animals.
Project involves vertebrate animals and was approved by the Institutional Animal Care and Use Committee (IACUC) on
(Date as mm/dd/yyyy)
This performing organization agrees to assume primary responsibility for complying with the Animal Welfare Act (7USC, 2131-2156),
Public Law 89-544, 1996, as amended, and the regulations promulgated thereunder by the Secretary of Agriculture in 9 CFR Parts
1,2,3, and 4. In the case of domesticated farm animals housed under farm conditions, the institutions shall adhere to the principles
stated in the Guide for the Care and Use of Agricultural Animals in Agricultural Research and Teaching, Federation of Animal Science
Societies, 1999.
http://daisy.uvm.edu/efd/forms416.exe (1 of 2) [4/1/2009 9:22:22 AM]

CRIS - Enter/Edit CSREES-2008

C. PROTECTION OF HUMAN SUBJECTS
Project does not involve use of human subjects.
Project involves use of human subjects and

Was approved by the Institutional Review Board (IRB) on
(Date as mm/dd/yyyy)
Performing Institution holds a Federalwide assurance number
(Single Project Assurance is no longer valid)
is exempt based on exemption number:
Specific plans involving human subjects depend upon completion of survey instruments, prior animal studies, or
development of material or procedures. No human subjects will be involved in research until approved by the IRB
and a revised form CSREES-2008 is submitted.
This performing organization agrees to assume primary responsibility for complying with the Federal Policy for Protection of Human
Subjects as set forth in 45 CFR Part 46, 1991, as amended, and USDA regulations set forth in 7 CFR 1c, 1992. All nonexempt
research involving human subjects must be approved and under continuing review by an IRB.

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http://daisy.uvm.edu/efd/forms416.exe (2 of 2) [4/1/2009 9:22:22 AM]