Form CSREES-2008 Assurance Statement(s)

NIFA Application Kit

NIFA-2008

NIFA Grant Application - State, Local & Tribal Gov't

OMB: 0524-0039

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UNITED STATES DEPARTMENT OF AGRICULTURE
NATIONAL INSTITUTE OF FOOD AND AGRICULTURE

OMB Approval 0524-0039

Assurance Statement(s)
STATEMENT OF POLICY - Institutions receiving NIFA funding for research
are responsible for protecting human subjects, providing humane treatment of
animals, and monitoring use of recombinant DNA. To provide for the adequate
discharge of this responsibility, NIFA policy requires an assurance by the

Institution’s Authorized Organizational Representative (AOR) that appropriate
committees in each institution have carried out the initial review of protocols
and will conduct continuing reviews of supported projects.
http://www.nifa.usda.gov/business/awards/assurance.html.

NOTE: Check appropriate statements, supplying additional information when necessary.
1. INSTITUTION

2. NIFA PROJECT NUMBER OR AWARD NUMBER (if known)

3. PROJECT DIRECTOR(S)

4. TITLE OF PROJECT

A.

BIOSAFETY OF RECOMBINANT DNA

G

Project does not involve recombinant DNA.

G

Project involves recombinant DNA and was either approved ( ) or determined to be exempt (
Institutional Biosafety Committee (IBC) on ______________ (Date).

) from the NIH Guidelines by an

This performing organization agrees to assume primary responsibility for complying with both the intent and procedures of the National Institute
of Health (NIH), DHHS Guidelines for Research Involving Recombinant DNA Molecules, as revised. A link to the guidelines can be found on the
NIFA web site at: http://www.nifa.usda.gov/business/awards/assurance.html.

B.

CARE AND USE OF ANIMALS

G

Project does not involve use of vertebrate animals.

G

Project involves use of vertebrate animals and was approved by the Institutional Animal Care and Use Committee (IACUC) on
_______________ (Date).

This performing organization agrees to assume primary responsibility for complying with the Animal Welfare Act (7 USC, 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 institution 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. Acess to the guide can be found
on the NIFA web site at: http://www.nifa.usda.gov/business/awards/assurance.html.

C.

PROTECTION OF HUMAN SUBJECTS

G

Project does not involve use of human subjects.

G

Project involves use of human subjects and

G

Was approved by the Institutional Review Board (IRB) on _______________ (Date). Performing Institutional holds a Federalwide
assurance number _______________.

G

Is exempt based on exemption number _______________.

G

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 NIFA-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. Additional information on the Federal Policy for Protection of Human Subjects
can be found at: http://www.nifa.usda.gov/business/awards/assurance.html.
Approved (signature):

Title:

Date:

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless
it displays a valid OMB control number. The valid OMB control number for this information collection is 0524-0039. The time required to complete this information
collection is estimated to average .50 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information
NIFA-2008 pdf 11/14/11 jri


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