China General Microbiological Culture Collection Center
No.1 Beichen West Road, Chaoyang District, Beijing 100101, Institute of Microbiology, Chinese Academy of Sciences
Tel.: 86-10-64807355 Fax: 86-10-64807288 E-mail： Homepage:
Deposition Data Sheet
Used only for an original deposit under Budapest Treaty
onthe International Recognitionof the Deposit of
Microorganisms for the Purposesof Patent Procedure
1. Taxonomic or Scientific name of biological material:
2. Identification reference given by depositor(number, symbol, etc.)
3. Is it a mixture of microorganisms? If so, please describe its components andat least one ofthemethods for checking their presence.
4. Recommended condition for cultivation and testing viability (medium, oxygen relationship, incubation temperature, incubation time, etc):
5. Country of origin of the biological material and source of isolation
6. Recommended Conditions for long term storage
7. Properties dangerous to health or environment
□ Yes ( □ human, □ animal, □ plant), □ No, □ unknown
If yes, please specify:
Risk group of the biological material: □risk group 1, □risk group 2
The biological material has to be handled under laboratory containment level:□ L1, □ L2
8. Other Comments:
I(We) understand and agree to the following:
1)I(We) request the CGMCC to deposit the biological material used for the purposes of patent procedure.
2)I(We) have read, agreed and compliedwith all items of the latest version of the CGMCC guideline for the deposit under Budapest Treaty on the International Recognition of the Deposit of Microorganisms for the Purposes of Patent Procedure.
3)I(We) agree that the biological material is to be stored for at least 30 years after the date of deposit, in any case, and for a period of at least five years after the most recent request for the furnishing of a sample of the deposited organism. I(we) undertake not to withdraw the deposit for the period specified in Rule 9.1 of Budapest Treaty.
4)I(We) will pay the fees for storage, viability test and providing samples.
9. Institution/legal entity:
Name of signing person(s) (typewritten):
□ on behalf of the legal entity, □ as private depositor(s)
Address:
Tel. / Fax / E-mailSignature: Date:
10. Name of patent agent(typewritten ):
Tel. / Fax / E-mailSignature: Date:
11. Director of China General Microbiological Culture Collection Center
Signature: Date: