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 I M7-7 !
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I I I University of Florida


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Department or Unit to Administer Account
CO-PRINCIPAL INVESTIGATOR


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Department
Title of Project:


College


Initials


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Social Security Number


College


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 FOR ALL APPLICABLE IDC ACCRUED, RETURN IDC TO: (CHECK ONE)
 (A) PI and Home Department, College
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 FACULTY OMIT __ ) PI and Center Only (No Department or College IDC return).
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NAME OF DEPARTMENTS) TO ACCRUE IDC, IF APPLICABLE I
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 CERTIFICATIONS AND ASSURANCES COST SHARING CONTACT PERSON:
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Human Subjects EJ l I I I I PROVIDED BY:I (name)
Animal Subjects L I L I PROVIDED B
Clinial Trials L (number)
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Recombinant DNA/RNA O questions about
 questions about
Biohazards l (If none, please check here): L this project.
TYPE: CATEGORY: MAILING INSTRUCTIONS:
New LO Research El Mail Original and copies to: (Check One)
Renewal El Training o __ First Class
Continuation U Extension El __ Federal Express
Supplemental O Other (Includes: ] Fedex Acc't. #
Revised O Fellowships, Conferences, Samas Acc't. #
 patient services, etc.) O___________ Other
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UPN IIIII PROPOSAL DATE: I--I--II--I II AGENCY CODE I I I I I

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DSR-I (8/94)


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