TEMPLE UNIVERSITY Office of the Vice Provost for Research Division of Research Compliance Institutional Biosafety Committee ~ AMENDMENT May 2015 Biosafety Registration Number: Associated ACUP number: Approval Date: NIH Category: Principal Investigator: Approval Date: Job Title Office Phone Cell/pager School/College/Center/Department and section (if applicable) Fax: Interoffice Address: e-mail address Project Title: Funded internally with department funds FOAPAL #: Funded externally by FOAPAL #: Is this protocol currently active? Yes please complete questions 1 to 4 No 1. Have there been any procedural changes (for example, in the viruses, vector systems or recombinant DNA/biohazards used or are they any changes ) since the last review? Yes No If yes, please attach a brief statement regarding the changes this may require IBC full approval. 2. Have you had any incidents or adverse event? Yes No If yes, please provide the date that was reported to IBC and if applicable to NIH 3. Is there any Change in Personnel? Yes please complete section below No Name Position TUID # Phone number add* remove add* remove add* remove add* remove add* remove add* remove * If you are adding personnel, please attach the dates of their required trainings and vaccinations. 4. Is there any change in approved location(s)? Yes please complete section below Building and Room number Type of work is performed if applicable add remove add remove PI’s Signature Signature, Chairperson, Institutional Biosafety Committee Date Approval Date No