SPANISH TYPE CULTURE COLLECTION

Parc Científic Universitat de València

C/ Catedrático Agustín Escardino, 9

46980 Paterna (Valencia), España

Tel.: +34 96 354 46 12

ACCESSION FORM FOR SAFE DEPOSIT OF STRAINS

Type of microorganism
bacteria archaea
fungi yeast

Strain description

*Scientific name (or proposed):
*Strain designation used by the depositor:
Is the microorganism genetically manipulated?YES (Fill in annex 1) NO
*Source of isolation:

Risk Assessment (Directive 2000/54/EC). CECT accepts strains belonging to risk group 1, 2 and 3(*)

*Risk group: group 1 group 2 group 3(*)
*Pathogenic for: humans animals plants specify:
Growth and maintenance
*Temperature ºC: *Time of incubation:
*Metabolism: AerobicFacultative anaerobe
MicroaerophilicStrict anaerobe
*Special requirements (light, gas phases, etc.)
Does this microorganism survive freezing? YES NO
*Culture medium (CECT number or composition):

Initial deposit period

1 year 5 years 10 years
AGREEMENT FOR DEPOSIT IN THE SAFE COLLECTION:
  1. The CECT will send the invoice corresponding to the initial deposit period and successive extensions of storage indicated by the depositor. Depositor has 3 months to make effective the payment. After this time and in case the payment of the invoice was not performed, the CECT reserves the right to destroy the deposited strain.
  2. CECT is not responsible for the authenticity and purity of the deposited strain if the confirmation form is not duly completed and returned after three monthssince the receipt of the preserved strain.
  3. According to the CBD (Convention on Biological Diversity), it is the depositor responsibility to ensure that the samples from which the strains were isolated, were collected according to the legislation of the country of origin and that the deposit of the strains in a secured collection does not infringe any national regulation. Delivery of the strain to third parties requires explicit consent of the depositor and it is his/her responsibility to inform the end user about any obligation regarding use and benefit sharing.
NOTE: Theundersignedcertifies that the informationprovided on this form is true. Thisstrainwill not be included inthepublic catalogueofthe CECT.The distributionof the strainisrestrictedto third partiesandwill not be deliveredwithout the permissionof the depositor.
*Billing information
Organization’s name:
Address:
VAT or TAX ID number:
*Depositor
CECT customer number or complete the information below:
Name:
Institution:
Address: Email:
Telephone:
Date:
Signature:

ANNEX I

Fill only if the microorganism if genetically manipulated

Please, attach reprints or complete as far as possible

In agreement to Spanish regulations (law 9/2003 and royal decree 178/2004) concerning genetic engineering, depositors are requested to provide information about:

Host organism:

Risk group:group 1group 2 group 3(*)
Pathogenicfor: humansanimals plants specify:
Sensitivities:
Resistances:
Auxotrophies:
Special properties (restriction / modification system, genetic recombination, etc.):

Donor organism:

Risk group:group 1group 2 group 3(*)
Pathogenicfor: humansanimals plants specify:
Description of the cloned DNA fragment (please, attach reprints or complete as far as possible):
Size of the cloned DNA fragment (in bp):
complete genomesubgenomicsubgenic

Fields marked with an asterisk (*) are compulsory Ed_07_20170201