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Format for submitting application to IBSC for recommendations/ to RCGM<br /> for permission to Import/ Exchange of GMOs/ LMOs and products thereof for<br /> Research and Development Purposes

FORM-1

Format for submitting application to IBSC for
recommendations/ to RCGM for permission to Import/ Exchange of GMOs/ LMOs and
products thereof for Research and Development Purposes


1.  

 

Name
of the Applicant

 

 

 

Designation

 

 

 

(a)
Address (Registered Office)

 

 

 

Telephone
No.

 

 

 

Telex
No.

 

 

 

Fax
No.

 

 

 

e-mail

 

 

 

 

 

 

 

(b)
Address (Research Station)

 

 

 

Telephone
No.

 

 

 

Telex
No.

 

 

 

Fax
No.

 

 

 

e-mail

 

 

 

 

 

2. 

 

Application
for (to indicate the purpose) :

 

 

 

 

 

3. 

 

Description
of the GMOs/ LMOs/ product thereof (in scientific terms in narrative manner
providing information on (a) Morphology; (b) Number of

 

 

 

 

copies
of the genes incorporated; (c) Status of approval is country of origin)

 

4.

 

 

 

 

 

 

 

 

 

5.

 

 

6.

 

 

 

 

 

 

 

 

 

 

7.

 

 

 

 

 

 

 

 

 

 

 

 

Source
of GMOs/ LMOs Products thereof:

 

Name
of the Agency

Contact
person’s

Address

Telephone
No.

Telex
No.

Fax
No.

e-mail

 

Quantity
of GMOs/ LMOs/ products thereof to be

Imported/
exchanged:

 

Details on:

(a)         
Source of
nucleic acid(s) :

(b)        
Nucleic
acid sequence (Please enclose the nucleic acid�� sequence map of the target gene) :

(c)         
Vector(s)
(Please enclose the map of the vector):

(d)        
Sequence
of the genes incorporated/ to be incorporated into the host organism.

(e)         
Host(s)
that carrying the vector(s)/ target gene(s) :

(f)          
Manipulative
procedures in outline :

 

 

Objectives
of the proposal:

 

 

8.

 

 

 

 

 

9. 

 

Summary of the proposed work plant utilizing GMOs/
LMOs/ products thereof:

(This should indicate schematic lab work, green
house whenever applicable)

 

 

 

Mode
of shipment :

 

 

 

 

 

 

10.

 

 

 

11.

 

Information on containment facilities installed at
R&D and production premises (whichever is applicable)

 

 

Standard Operating Procedures (SOP) on
decontamination, disposal mechanisms & risk management (in brief) :

 

 

 

 

 

12. 

 

Any
other relevant points(s)

 

 

13. 

 

 

Declaration
:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare that the information provided in
the above format is correct and accurate to the best of my knowledge. The
"Biosafety Guidelines" brought out by the Department of
Biotechnology, Ministry of Science & Technology, Govt. of India will be
and is being strictly followed. The imported/ exchanged material will be
utilized for the said purpose only. In case any untoward incident occurs, the
Chairman of the IBSC and the Member-Secretary of the RCGM will be informed
immediately.

 

 

Place:

 

Date:���������������������������������������������������������������������
Signature of the Applicant

 

 

 

14.

 

 

 

Recommendations:

 

 

The proposal
set out above has been considered by the �Institutional Biosafety Committee�
in its meeting held on __________________ and is forwarded and recommended to
RCGM for further necessary action.

 

 

Place:

 

Date:�������������������������������� Signature
of the Chairman, IBSC

 

 

 

 

(Note:
Please submit 20 copies of the application to the Department of Biotechnology
for placing the same in the meeting of RCGM)