DEPOSITOR INFORMATION
Name of Depositor/Company/Institute (NB this will be the name that appears on certification)
Contact Name
Depositor Address
Tel No
Fax No
Email Address
BIOHAZARD RISK ASSESSMENT MUST BE ENCLOSED
The deposit is made in accordance with the terms of the Budapest Treaty 1977. I agree to abide by the conditions and regulations regarding the deposit of cell lines to ECACC.
Name
Date
Invoice Address (if different from above)
Cell line for deposition
Brief description
DETAILS OF CELL CULTURE
Identification/Name in full
Species and strain
Organ/Tissue
HYBRIDOMAS
Immunogen
Immunocyte donor
Immortal partner
Product Specificity
Ig class/subclass
Screening Assay
ADDITIONAL INFORMATION
Full cell line name
Cell products/characteristics
Morphology
Passage No
Growth as suspension/attached line
CELL STORAGE CONDITIONS
Cell concentration
Composition of medium
CULTURE CONDITIONS
Growth medium
% Serum and type
Supplements (& conc)
Temperature
Gaseous phase
Split ratio (attached)
or (suspension) cells/ml
STERILITY CHECKS ALREADY PERFORMED
Bacteria	Yes    No
Mycoplasma	Yes    No
Fungi	Yes    No
Viruses	Yes    No
ANY OTHER RELEVANT INFORMATION