A National facility established in 1951

ACCESSION FORM FOR GENERAL DEPOSIT OF MICROBIAL STRAIN

General deposit of–Bacteria/ Fungi/ Yeasts/ Algae

(Please fill manually, sign and print and submit hard copy/scanned hard copy)

I] Depositor’s information

Name of depositor
Prof./Dr.
Address of depositor
(Official)
Contact information / Tel, Mobile / Fax / Email
Isolated by (Person)
Isolated on (mm/dd/yyyy)-
Received from*
(Name, address) / *Applicable, only if strain is received fromother than of the depositor lab; If strain is under MTA agreement, kindly enclose the same.

II] Strain origin and history

Details / Genus / Species (sub-species/variety)
Strain designation
e.g. Bacillus megaterium (strain A1)
Gram’s nature, shape (For bacteria)
Microscopy observation
(other than bacteria)
Equivalent strain designations (or collection numbers) other than NCIM; Yes or NO / If yes, then mention the accession number (s)
(e.g. ATCC 1234)
Risk group/Biosafety level 1 or 2
(If not sure then use literature info)
Only BSL-1 is acceptable
Convention on Biological Diversity (CBD) related information (Compulsory)
for details / Sampling agreement- Prior Informed Consent (PIC): Yes/No/Not applicable/Don’t know(Underline correct option). Not applicable and Don’t know are similar terms.
Organization/Authority who issued PIC:
NCIM will not accept a culture without this information.
Source of isolation (soil, water etc.)
Geography (place, state)
Country of origin

III] Recommended conditions for cultivation (Use separate sheets if required)

Growth/Maintenance medium
or commercially available medium
(name and composition or cat. No. for commercial medium)
Optimum pH of medium
Optimum temperature (°C) and time (hours) required
Aerobic/anaerobic/ microaerophilic
Tentative sub-culturing period (days)
Pigmentation or any other unique characteristic (for quick observation)
Industrial/ biotechnological application (s)/
Taxonomic novelty
(at least one is compulsory)
Please note: Biochemical test results not qualifies for application.
Publication (in peer reviewed journals cited by ISI/ Thompson Reuters/ SCOPUS)/Reference if any –

IV] Strain identification information (please attach additional sheet, if needed)

Note: Strain will not be accepted for deposit without the sequencing information. If you don’t have sequencing data, kindly utilize NCIM’s authentic, and rapid sequencing services. Kindly contact us !

Please tick mark or round mark the following. If not relevant- leave unattended.

  1. Molecular identification/Sequencing information is provided with this sheet?-- *Yes or NO

* (Sequencing charges will be applicable if no sequence information provided and/or mis-match/conflict between depositor’s and NCIM’s sequence analysis before assigning strain accession number.

  1. Genbank/NCBI/EMBL/DDBJ accession number-(of the same strain, if known)-
  2. If sequence not yet deposited in GenBank- then submit rawdata (fasta files) (on separate sheet. NCIM will not be liable for submitting the sequence in GenBank database.
  3. Supplementary information- Biochemical tests, sugar assimilation results done by API/Vitek/ Biolog/etc.
  4. Any other information depositor wants to mention.

UNDERTAKING/ AGREEMENT FOR DEPOSIT IN PUBLIC COLLECTION

It is certified that the culture is non-pathogenic / non-hazardous in nature.(Select correct option)

Whether the culture is for common distribution (Yes / No): (If it is not for common distribution, NCIM may charge you for maintenance; please contact for charges)

(I/we hereby authorize that culture deposited shall be without any encumbrances and shall becometheproperty of NCIM Resource Center. NCIMhave rights to distribute/supply the culture (s) for general, R & D, and for commercial exploitationupon request, without any liability to the depositor).

Signature of Depositor/ Principal investigator/ Scientist (Date and seal)

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FOR NCIM OFFICE USE ONLY

Culture received for deposit on-QC match (Y/N)-

NCIM accession number-Assigned on-

For related query, please write to - ; or call us 020-25902454/2670

NCIM General deposit form