Institutional Animal Care and Use Committee

Animal Care and Use Protocol -Annual Report

Use this form to renew the annual approval of your ACUP or close your ACUP after all live animal work is complete.

Email the completed form to the IACUC office () 1 month before your ACUP’s annual expiration.

Principal Investigator:

Phone:

Email:

Department/College:

Granting Agency:

ACUP #:

Project Title:

ACUP Approval Year First Second Third / Final

PART I.

  1. Were there any unexpectedadverse events that affected the animals during your work this year?

Yes No

If yes, please describe:

  1. What type of report are you filing? – Check only one option and respond to the associated questions

ANNUAL RENEWAL

Note: Any changes to your ACUP (e.g. participants, locations, procedures, animal numbers, funding, subcontracts, etc.) must be communicated to the IACUC as an amendment. Forms here

FINAL REPORT

  • When should the IACUC close this ACUP?

Upon receiving this form

On the annual expiration date

  • Will you apply for a new ACUP to continue this work? Form here

Yes No

Reminder: The final disposition of all animals must match the specifications in your approved ACUP. No live animals can remain on an expired ACUP. If live OSU-owned or OSU client-owned animals remain, they must be returned to their respective herds, approved ACUPs, or clients. If you intend to transfer the remaining live animals to a new ACUP, you must obtain IACUC approval before your current ACUP expires. Otherwise, any remaining live animals must be transferred to the Attending Veterinarian’s holding ACUP.

PART II. Complete the table on the following page withacount,per pain category, of animals usedin the past year.

***Blank fields in any pain category will be interpreted asZEROS***

For Field Studies: If species were captured that are not on the ACUP, please include them in the table.

Pain/Distress/Discomfort Category Summaries Link to OSU Pain & Distress Policy

Species used in the past year (common name) / Enteranimals into the highest pain/distress categoryexperienced
Category C / Category D / Category E / Total
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total / 0 / 0 / 0 / 0

(Office Use Only)

IACUC Approved signature:, signature on file Reviewer: Date:

Oregon State University Institutional Animal Care and Use Committee

ACUP Annual Report Form, January 2017 Page 1 of 2