Form_B3
INFORMATION ON GENETIC MODIFICATION
1. Method used for genetic modification (please, tick)
insertion
deletion
combination between deletion and insertion
cell fusion
other (please, specify)
2. Expected result from the genetic modification
3.
Use of a vector for the genetic modification?
Yes
If no, please go directly to question 12.
If yes, please, specify:
(+) genetic map of the vector
Presence of the vector into the final GMO (please,
tick)
No
full
partial (please, specify)
4. Type of the vector (please, district)
plasmid
bacteriophage
virus
cosmid
phagemid
transposon
other (please, specify)
5. Identity of the vector
5.1. If the vector used is commercially available and if the information, required at item 5 is contained in the
catalogue of the supplying company, please, enclose the company’s information (company, page from the
catalogue and other) including map of the vector.
5.2. When the vector used is not commercially available or has been modified compare to the commercially
available vector, please give detail information for its construction, including name and source of each part
of it.
6.
Presence of nucleic sequences in the vector, which confer selective or identification phenotype (please,
tick all the relevant fields and specify).
Resistance to antibiotic
Resistance to heavy metal
Resistance to pesticide
Other (please, specify)
7. Frequency of mobilisation and/or ability for genetic transfer, and methods for its identification:
8. Information on the degree to which the vector is limited to the DNA required to perform the intended
functions:
9. Does the vector have an own transfer system?
Yes
No
If yes, please explain:
10. Does the vector have tumorogenic potential?
Yes
No
Not known
If yes, what kind?
11. Method used for introducing the vector into the recipient organism (please, tick)
transformation
electroporation
macroinjection
microinjection
infection
other (please, specify)
12. In the case, where a vector is not used for the genetic modification, indicate the method of introduction
of the inserted DNA into the recipient organism.
transformation
macroinjection
microinjection
microincapsulation
other (please, specify)
13. Information for the inserted genetic material
Please, attach a genetic map of the inserted genetic material .
13.1. Characteristic of the inserted sequence:
(coding sequences, phenotype markers, types and characteristics of the product,
noncoding sequences and regulatory signals – types, functions and specificity, also their effect over the
expression and mobilisation):
Components of the
inserted genetic
material
size
locality
Nucleic
sequence
source
Expected
function
13.2.Make an assessment of the biological biosafety of the nucleic material, which will be transferred
(i.e. the inserted sequence), taking into account the purity from each unknown sequence and the
degree of its characterization:
14. Methods, used for the genetic modification (for constructing of the vector or for deletion of nucleic
sequence):
15. Localisation of the modified nucleic acid (inserted or deleted) at the end construction of GMO (please,
tick)
On a free plasmid
Integrated into chromosome
Other (please, specify)
16. Copy number of the inserted nucleic acid
17. Expression of the inserted nucleic acid
Level of expression (including description and
sensibility of the method)
Activity of the expressed protein(s)
Tissue- and lifecycle-specificity of the expression
(only for GM higher plants)
18. Size, nucleic sequence and function of the deleted nucleic acid
19. Does the inserted/deleted genetic material contain any parts with unknown function?
Yes
No
If yes, please explain:
20. Does the inserted/deleted genetic material contain any sequences, conferring pathogenic or other
harmful characteristics of the donor organism or vector?
Yes
No
If yes, please explain:
21. Description of the methods for detection and identification (please, specify)
Method(s) for detection of the inserted sequence and
the vector
Method(s) for identification of the altered part of the
nucleic material (in case of deletion)
22. Sensibility and reliability regarding quantity and specificity of the techniques for detection and
identification:
23.
Name, family
Notifier
Project leader
Biosafety officer
Date, place
Signature