CHILDREN YOUTH AND WOMEN'S HEALTH SERVICE Institutional Biosafety Committee IBC reference No. Exempt Dealing Evaluation Report The CYWHS Institutional Biosafety Committee (IBC) must be notified of and approve all work which falls under the OTGR Guidelines (http://www.ogtr.gov.au/pubform/handbook) irrespective of whether the work is exempt under Part 1 of Schedule 2 of the regulations. This form must be completed when Exempt Dealing approval is required, along with an IBC Project Application and Evaluation Report form. A copy should be kept by the investigator and the original plus 12 copies of all forms and attachments be forwarded to IBC Executive Officer, Research Secretariat, Level 2, Samuel Way Building, Children Youth and Women's Health Service, 72 King William Rd, North Adelaide. Queries to tel: 8161 6390. 1 Project Supervisor: 2 Project Title 3 Exemption category: 1. Any dealing with gene-knockout mice (ie mice whose genetic modification involves deletion or activation of a specific gene), if no advantage is conferred on the adult animal: (a) by the deletion or inactivation of the gene concerned; or (b) for mice that also carry a selectable marker gene–by the selectable marker gene 2. any dealing with a whole animal, if: (a) naked recombinant nucleic acid has been introduced into its somatic cells; and (b) the introduced nucleic acid is incapable of giving rise to infectious agents 3. any dealing with an animal into which genetically modified somatic cells have been introduced, unless the cells: (a) are capable of giving rise to recombinant infectious agents; or (b) certain viral sequences that could recombine with, or be complemented by, genomes of introduced superinfecting viruses 4. any dealing involving a host/vector system mentioned in Part 2 of the Schedule and producing no more than 10 litres of GMO culture, if: (a ) the donor DNA: (i) is not derived from micro-organisms capable of causing disease in human beings, other animals, plants or fungi, or is fully characterised and will not increase the virulence or host range of the host or vector; and (ii) is not an oncogene; and (iii) does not code for a toxin for vertebrates with an LD50 of less than 100 µg/kg; and (iv) does not code for a toxin for vertebrates with an LD50 of 100 µg/kg or more, if the intention is to express the toxin at high levels; and (v) is not uncharacterised DNA from a micro-organism that produces toxins with an LD50 of 100 µg/kg or less; or (b) the donor DNA includes a viral sequence or viral sequences, but: (i) is missing at least 1 gene essential for viral multiplication that is not available in the cell into which the DNA is introduced and that will not become available through subsequent breeding; and (ii) is incapable of complementing a defect in the host/vector system. 5. 4 GMO (delete those that do not apply): Any dealing involving shot-gun cloning of mammalian DNA in a host/vector system mentioned in Part 2 of the Schedule. Class of GMO Algae Animal Bacteria Fungi Plant Protozoa Virus 5 Details Modified trait(s) and gene(s) responsible: Class of modified trait Virus resistance Fungal resistance Bacterial resistance Disease resistance Pest resistance Herbicide resistance Antibiotic resistance Pesticide resistance Abiotic stress resistance Altered agronomic characteristics Altered horticultural characteristics Altered physical characteristics Altered physiological characteristics Altered pharmaceutical characteristics Attenuation Antigen expression Protein expression Growth factor expression Altered bioscience characteristics Altered bioremediation characteristics Altered biocontrol characteristics Reporter/marker gene expression Immuno-modulatory protein expression Other 6 Facilities to be used (include containment level): 7 Commencement date: 8 Completion date: Details 9 IBC declaration: The IBC has evaluated this dealing and agrees that it is an exempt dealing as specified by Schedule 2 of the Gene Technology Regulations 2001. Name of Accredited Organisation: Children Youth and Women's Health Service Name of IBC chair: Signature of IBC chair: last updated 12 October 2007 Date: / /