Ana G. Méndez University System
VICE PRESIDENCY FOR PLANNING AND ACADEMIC AFFAIRS
ASSOCIATE VICE PRESIDENCY FOR SPONSORED PROGRAMS AND COMPLIANCE
OFFICE OF REGULATORY COMPLIANCE
IBC Form 7
Continuing Review / Notice of Transfer or Termination
Continuing Review: If you wish to continue your IBC Registration of biohazardous materials
(biological agent, chemical agents, rDNA or rRNA), you must complete this form and submit it to the
IBC at least one month prior to the end of the current approved period.
Transfer: If, at any time, you wish to transfer possession of a registered material, complete this
form and submit it to the IBC. No transfer of previously registered materials shall occur until IBC
approval is obtained.
Termination: If, at any time, you wish to terminate your use or possession of any registered material
complete this form and submit it to the IBC. Make sure you complete the form for each previously
registered material. No disposal of registered material shall occur until IBC approval is obtained.
IBC Number:
I. Mentor/ Co-Investigator
1. Mentor/ Co-investigator’s
Name:
2. E-mail:
3. Phone/ Fax:
4. Department/School:
5. AGMUS Institution:
II. Protocol Status
Active - project on-going
1. Indicate the status of this
project:
Inactive - anticipated start date:
Completed - no further activities will be performed
under this protocol.
IV. Project/ Protocol Basic information
Please list the biohazardous agent(s) (biological, chemical or rDNA/rRNA) used for this
research. Be specific to include species name, stain designation, cell line source/designation,
and other information about the agent to help in this review process.
P.O. Box 21345 San Juan, PR 00928-1345
Phone: 787-751-0178 ext. 7195, 7197 FAX: 787-759-6411
compliance.suagm.edu
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AGMUS IBC-09
April-2012
V. Type of request
Request for Continuation, Notice of Termination or Transfer (please choose one only):
I request continued IBC approval of my use/possession of the previously registered
material described above.
I request termination of IBC approval. Attach is a separate sheet describing when and how
the biohazardous material(s) identified above will be disposed off.
I request to transfer possession of the registered material described above to:
_______________ . If the transferee is an AGMUS faculty member or employee, the
transferee must complete and submit the appropriate IBC Registration Forms (IBC Form 1
or Form 2) to the IBC and receive approval before transfer of the material can occur.
Furthermore, the transferee shall have his/her laboratory registered with the IBC (Form 5),
before transfer of any material can occur. If the transfer is to another institution or individual
outside AGMUS, contact the Office of Regulatory Compliance.
If requesting continued IBC approval, indicate whether:
1. The Principal Investigator will change
Yes*
No
2. The Risk Group (RG) will change?
Yes*
No
3. The Biosafety Level (BSL) will change?
Yes*
No
4. The type or amount of the registered material will change?
Yes*
No
5. The registered material will be moved to another laboratory?
Yes*
No
6. The use of the registered material will change?
Yes *
No
7. The identity of the registered biological agent will change?
If yes, explain:
Yes *
No
*If the answer to any of the above questions (1–7) is yes, you must submit an IBC Changes Form
(IBC Form 8) to the IBC for approval before making any of these changes. Furthermore, if the
registered material will be moved to another laboratory, the Principal Investigator or Director of the
laboratory in question should complete and send IBC Form 5 for the IBC approval. No registered
materials should be moved to unregistered laboratories. Once the material is moved, the Principal
Investigator of the laboratory shall register the material under his/her name.
VI. Adverse/ unanticipated Events
a. Have any adverse events occurred since registration approval or
last request for continuing approval?
*If yes, was an adverse Event Report Form (IBC Form 4) submitted
to the IBC?
IBC_Continuing_Review_Notice_of_Termination_07
Revised (4/2012)
2
Yes*
No
Yes
No
AGMUS IBC-09
VII.
Certification
 I certify that the above information accurately describes the current status of the registered
material that was previously approved by the IBC.
Signature of Principal Investigator
/
/
(mm/dd/yy)
Signature of Dean
/
/
(mm/dd/yy)
/
/
Submit this completed form to the AGMUS’ Office of Regulatory Compliance.
IBC Use Only
Date Recieved:
/
/
/ (mm/dd/yy)
Continuation Approved
Transfer Approved
Continuation Disapproved
Transfer Disapproved
/
/
(mm/dd/yy)
IBC Chair Signature
Termination Approved
/
IBC-signed copy returned to Registrant and/or Transferee.
IBC_Continuing_Review_Notice_of_Termination_07
Revised (4/2012)
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AGMUS IBC-09