UCSC Transgenic Animal Registration Form

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UC Santa Cruz – Institutional Biosafety Committee (IBC)
Transgenic Animal Registration
Registration of the following must be submitted and approved by the IBC
prior to creation of these animals:
 Generation of all transgenic animals (other than rodents that can be
housed under Biosafety Level (BSL1) containment conditions).
 Generation of transgenic rodents requiring BSL2 or higher containment
(e.g. those created with the use of certain viral vectors, or those that may
express harmful proteins).
 Breeding of two different strains of transgenic (including knock-out*)
animals, including rodents, where one or both animals require BSL2 or
higher containment.
Registration of the following may be submitted to the IBC concurrent to
creation of these animals:
 Experiments involving the creation of transgenic rodents that can be
housed under Biosafety Level 1.
 Breeding of two different strains of transgenic (including knock-out*)
animals, including rodents, that requires BSL1 containment.
* The techniques used initially to create knock-out animals involve the stable
introduction of recombinant DNA into the animal’s genome, and thus these
animals are considered transgenic under the NIH Guidelines.
Please note: The purchase or transfer of transgenic rodents that may be
maintained at BSL1 containment are exempt from the NIH Guidelines;
however, no other animals are exempt (including phylogenetically lesser
species).
UCSC Transgenic Animal Registration
Page 1 of 3
09/2009
Principal Investigator and Contact Information
Responsible Faculty/PI:
Principal Investigator:
Division and Department:
UC Employee ID:
Address/Mail Code:
Office Phone:
E-Mail:
Lab Extension
Emergency/Home Phone:
Fax:
You must have at least one alternate contact that can respond to an emergency, answer questions for
the Committee or an Inspector and/or will always be able to contact you.
Alternate Contact:
(Preferably an SRA, Lab Manager or Co-PI – Someone with responsibility for the lab who is
informed of the research protocols and emergency response procedures)
Lab Contact
Job Title:
Division and Department:
UC Employee ID:
Address/Mail Code:
Office Phone:
E-Mail:
Lab Extension
Emergency/Home Phone:
Fax:
By signing below, I certify that I have read the following statements and agree that I and all listed
participants will abide by those statements and all UC policies and procedures governing the use of
recombinant DNA as outlined in this registration and in the following:
NIH recombinant DNA Guidelines (http://www4.od.nih.gov/oba/rac/guidelines/guidelines.html)
Signature of Principal Investigator:
UCSC Transgenic Animal Registration
Date:
Page 2 of 3
09/2009
Genetically Modified Animals
List EACH animal separately:

Spell out acronyms or abbreviations

If the transgenic animal poses a known hazard, animal containment may need to be reassessed. Contact Biosafety x9-3542 or
email biosafety@ucsc.edu for risk assessment assistance.

DO NOT LIST NATURALLY OCCURRING/SPONTANEOUS/CHEMICAL OR RADIATION INDUCED MUTATIONS.
Animal
Species
Gene Name and function
UCSC Biological Use Authorization
Biological
Source of Gene
Page 3 of 3
Type
Source of
Transgenic
Animal
Hazard
Knockout
PI's Lab
No known hazard
If other specify:
If other specify:
If other specify:
Knockout
PI's Lab
No known hazard
If other specify:
If other specify:
If other specify:
Knockout
PI's Lab
No known hazard
If other specify:
If other specify:
If other specify:
Knockout
PI's Lab
No known hazard
If other specify:
If other specify:
If other specify:
Knockout
PI's Lab
No known hazard
If other specify:
If other specify:
If other specify:
December 2007
If a hazard exists,
describe precaution
for animal handlers
and housing
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