Principal Investigator Assurance

^{Blankettnr: 211}

This form must be signed and submitted with all applications, progress reports, and requests for prior approval to federal American funding agencies. When there are more than one Principal Investigator in an application to a federal American funding agency (in a so called “Multiple PI application”), separate assurances must be signed by each PI.

This form is designed to comply with the requirements of NIH Notice NOT-OD-06-054, issued April 7 2006.

• I am filling out the form below as: - - - the main applicant/recipient the sub-applicant

• General project application information

• Funding agency:
  Tecken kvar
• Project title:
  Tecken kvar
• Department of Principal Investigator (PI) at UU
  Tecken kvar
• Name of Principal Investigator (PI) at UU
  Tecken kvar
• Funding Opportunity Title:
  Tecken kvar
• Funding Opportunity Number:
  Tecken kvar
• Name of main applicant Principal Investigator (PI):
  Tecken kvar
• Main applicant organization:
  Tecken kvar
• Submission type: - - - New grant application Progress report Prior approval request
• Funding Opportunity title:
  Tecken kvar
• Funding Opportunity Number:
  Tecken kvar
• Federal award identification number (FAIN):
  Tecken kvar
• Indicate request type (e.g., project extension; carryover of funds; change in scope, key personnel, or recipient organization):
  Tecken kvar
• Federal award identification number (FAIN):
  Tecken kvar

• Special features of the project

• Are human subjects included in the project? - - - Yes No
• Does the project include the use of animals? - - - Yes No
• Does the project include the use of human stem cells? - - - Yes No

• Certification statement

• Main Applicant Certification

  Please download this certification of disclosure document:

  Certification statement

  Fill out the certification of disclosure document and upload it to the "Attach a document with your digital signature" below.

• Sub-applicant Certification
  

  Please download this certification of disclosure document:
  

  Certification statement
  

  Fill out the certification of disclosure document and upload it to the "Attach a document with your digital signature" below.

• Attach a document with your digital signature
  Bläddra...

  
  
  • ()

• Please note: When you submit your application, please do not close your browser until you have been redirected to another page with a confirmation of a successfully received application.