Program Director/Principal Investigator Assurance
It is a compliance requirement that the applicant organization must secure and retain a
written assurance from the Principal Investigator (PI) prior to submitting an application
to the PHS. This assurance must be available to the sponsoring agency or other
authorized HHS or Federal officials upon request.
As PI/PD for an application (including non-competitive renewal) to the National
Institutes of Health, I certify that:
1) the information submitted within the application referenced below is true, complete
and accurate to the best of the my knowledge;
2) any false, fictitious, or fraudulent statements or claims may subject me to criminal,
civil, or administrative penalties; and
3) I agree to accept responsibility for the scientific conduct of the project and to provide
the required progress reports if a grant is awarded as a result of the application.
4) I agree to abide by the terms of the Bayh-Dole Act and the NIH Grants Policy
Statement as they relate to intellectual property rights.
Deadline date or date submitted
_____________________________
Print Name and Title
Signature
Date
NIH ID# if available (or NIH Program)