Institutional Review Board (IRB)
CHARGE FOR IRB REVIEW
OF COMMERCIALLY SPONSORED PROJECTS
The charge for IRB review is a one-time only fee of $2500.00 per IRB review which will
include all subsequent amendments and continuing review.
If this commercially sponsored research project should be granted a waiver of the onetime only IRB review fee (i.e., a small grant or contract), written justification in the form
of a separate letter must be submitted to the IRB administrative office.
Please complete the following information and submit this form to:
UNMC/UNO/Children’s Hospital & Medical Center IRB, Room 3000,
Academic and Research Service Building, Zip 7830.
IRB #
Title of IRB Proposal:
Identification of Commercial Sponsor:
Method of payment for one-time IRB fee of $2500.00:
___ Payment Attached Direct from Commercial Sponsor, check #
___ Company/Center Number to be Direct Billed, c/c #
___ Company/Center Number applied for, c/c Number Pending
The investigator will notify the IRB when the grant account is open, to be direct billed.
___ A waiver of the one-time IRB review fee is requested.
A separate letter of justification is attached.
___ Other (please specify):
____________________________________
Signature of Principal Investigator
__________
Date
08-04-2011 gdk
Academic Research & Services Building 3000 / 987830 Nebraska Medical Center / Omaha NE 68198-7830
402-559-6463 / FAX 402-559-3300 / Email: irbora@unmc.edu / http://www.unmc.edu/irb