Amendment to Registration

Possession, Use, and Transfer of Select Agents and Toxins (42 CFR 73)

Attachment 9 - Amendment to a Certificate of Registration.xlsx

Amendment to a Certificate of Registration

OMB: 0920-0576

Document [xlsx]
Download: xlsx | pdf
This application is:

____________________________
Date












Entity name: Entity registration number (e.g., A00000000-0000):


































SECTION 6 – BIOSAFETY AND LABORATORY INFORMATION ON SELECT AGENTS AND TOXINS












Make additional copies of this section of the form as needed for each PI at your entity. Each PI should complete the appropriate section for



















laboratories under his/her control where select agents are used or stored. For information on completing this section, refer to page 3 (B)(7) of the



















guidance document.



















SECTION 6A – TO BE COMPLETED BY ALL ENTITIES FOR EACH PRINCIPAL INVESTIGATOR












Provide the following information on a separate line for each laboratory safety level: the select agent or toxin; the strain designation of the select



















agent or toxin, the building and room number(s) where each select agent or toxin will be used and stored, and laboratory safety level for each PI (or



















Chief Scientist). For entities only storing and not actively working with select agents or toxins, do not complete “laboratory area” column. For



















information on completing this section, refer to page 3 (B)(7) of the guidance document.



















Select Agent/Toxin Strain Designation
(list “N/A” if not applicable or “TBA” if to be acquired)
Laboratory Area Storage Area Laboratory Safety Level* Principal Investigator












Bldg Room Bldg Room




















































































































































































*Biosafety Level 2=BSL2 Animal Biosafety Level 2=ABSL2 rDNA BSL2=NIHBL2 rDNA Large Animal BSL2=NIH BL2N rDNA Large Scale BSL2=NIH BL2-LS



















Biosafety Level 3=BSL3 Animal Biosafety Level 3=ABSL3 rDNA BSL3=NIHBL3 rDNA Large Animal BSL3=NIH BL3N rDNA Large Scale BSL3=NIH BL3-LS



















Biosafety Level 4=BSL4 Animal Biosafety Level 4=ABSL4 rDNA BSL4=NIHBL4 rDNA Large Animal BSL4=NIH BL4N rDNA Large Scale BSL4=NIH BL4-LS



















Plant=BSL2 Plant=BSL3 Biosafety Level 3 Agriculture=BSL3ag Toxin= 29 CFR 1910.1450, 29 CFR 1910.1200 and BMBL
























































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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