PHS-FITS Confirmation Form
Date:
Award Title:
Institution Number:
Award Number:
Investigators participating in this research
I have confirmed with the Principal Investigator that the below is a complete list of
Investigators (individuals responsible for the design, conduct or reporting of this research),
including but not limited to key personnel, consultants and collaborators (you may enter
multiple names in each text box below.):
Penn Investigators:
Click here to enter text.
Non-Penn Subaward Investigators:
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Other Non-Penn Investigators (e.g., consultants and collaborators):
Click here to enter text.
I confirm that all Penn Investigators have submitted a current PHS-FITS, including a
Relatedness Assessment for this research.
I confirm that all Penn Investigators have completed the Financial Conflicts of Interest in
Research Investigator Training Course – OVPR.
Business Administrator Certification
I certify that the above information is complete and accurate to the best of my knowledge.
Type Name
Business Administrator
Signature:
School:
Department: