REQUEST FOR TRANSFER OF EXPERIMENTAL ANIMALS
DEPARTMENT OF LABORATORY ANIMAL RESOURCES
ROOM 113D - Ext. 6166

Transfer Request form

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TRANSFER FROM: (to be completed by principal investigator transferring animals)
 

PR. INVESTIGATOR	P.I. on protocol
DEPARTMENT	P.I.s department
PROTOCOL NUMBER	IACUC protocol number
ACCOUNT NUMBER	Account number must correspond to protocol number (see the New Account Memorandum)
ACCOUNT EXPIRATION	Account's expiration date (Animals cannot be ordered to come in after the expiration of the Grant)
ROOM NUMBER WHERE ANIMALS LOCATED	Room number of the room the animals are currently be housed in.
AUTHORIZED SIGNATURE	This must be the signature of a person authorized to sign for the account indicated above.
LAR CODE	FOR LAR USE ONLY!

   

Animal	Quantity	Sex		Age/Weight	Strain	Date Transferred	USDA  A, B1, B2, C, D
Such as Mice, Rat or Gerbil. Please submit one order form per species.	Indicate the number of animals to be transferred.			Such as 11-12 wks old, 150-200 gm, or 20 days preg.  Age and weight should be given as a range.	Such as Balb/C, Sprague-Dawley, SCID, etc.	Date when animals are to be transferred to the transferee.	This should match the animals' classification indicated in the protocol number.

  PLEASE SPECIFY BY CHECKING APPROPRIATE BOX:

_ TRANSFER ALL ANIMALS ON THIS PROTOCOL _ TRANSFER OF PARTIAL ANIMALS ON PROTOCOL

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TRANSFER TO: (to be completed by principal investigator receiving animals)
 

PR. INVESTIGATOR	P.I. on protocol
DEPARTMENT	P.I.s department
PROTOCOL NUMBER	IACUC protocol number
ACCOUNT NUMBER	Account number must correspond to protocol number (see the New Account Memorandum)
ACCOUNT EXPIRATION	Account's expiration date (Animals cannot be ordered to come in after the expiration of the Grant)
DLAR CODE	FOR DLAR USE ONLY!
AUTHORIZED SIGNATURE	This must be the signature of a person authorized to sign for the account indicated above.
ANIMAL INVENTORY BALANCE	FOR DLAR USE ONLY!

   

Animal	Quantity	Sex		Age/Weight	Strain	Date Transferred	USDA  A, B1, B2, C, D
Such as Mice, Rat or Gerbil. Please submit one order form per species.	Indicate the number of animals to be transferred.			Such as 11-12 wks old, 150-200 gm, or 20 days preg.  Age and weight should be given as a range.	Such as Balb/C, Sprague-Dawley, SCID, etc.	Date when animals are to be transferred to the transferee.	This should match the animals' classification indicated in the protocol number.

Additional information:

• Per Diem Rates
• Request for Order of Experimental Animals
• Factors to Consider When Calculating Costs for the Purchase of Animals Under an Approved Protocol

. . .

Transfer Request form

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