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)
PLASMID INFORMATION
Name of plasmid
Suggested host(s)
Molecular weight of Vector
Molecular weight of Insert
Restriction enzyme cloning site
Selection Marker
Cloned DNA Sequence
Is the cloned sequence expressed?	Yes    No
Does the cloned sequence code for toxic or potentially infectious products?	Yes    No
If YES please enclose details
References (please enclose a copy)
HOST INFORMATION
Scientific name of host
Strain Designation
Culture requirements (enclose ref if appropriate)
GMO Category
Accessioning of deposits cannot start until this information is available. ECACC can perform this risk assessment but it will take three months to complete. A charge will be levied for this.  A Biohazard Risk Assesment must be completed in order for your samples to be accepted.  ECACC is required to asess the GMO status of all deposits PRIOR to receipt.  Therefore, we will contact all depositors to advise them when we can receive samples