01.01.2015 Views

BEI RESOURCE DEPOSIT FORM FOR - BEI Resources

BEI RESOURCE DEPOSIT FORM FOR - BEI Resources

BEI RESOURCE DEPOSIT FORM FOR - BEI Resources

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

IN<strong><strong>FOR</strong>M</strong>ATION REQUIRED <strong>FOR</strong> <strong>DEPOSIT</strong><br />

INSTRUCTIONS TO <strong>DEPOSIT</strong>OR: Please fill in the relevant and available information about each deposit, and return<br />

electronically to the collection scientist, or fax to 703-365-2725, prior to shipping the Material. Two printed and<br />

signed originals of part 1 of 2 must also be sent prior to the shipment. Additional information, references or pages<br />

may be attached as needed. This information helps us better characterize and preserve the Materials.<br />

The “MATERIAL” subject to this Deposit Form is:<br />

Name of Antibody/antiserum/hybridoma:________________________________________________________<br />

1. BACKGROUND IN<strong><strong>FOR</strong>M</strong>ATION:<br />

a. Name of investigator who developed the material & name of investigator’s institution:<br />

_____________________________________________________________________________________<br />

b. Reason you feel this antibody is important: ____________________________________________________<br />

_____________________________________________________________________________________<br />

c. References: Original description or other appropriate publications. Please enclose a copy of relevant<br />

references. ___________________________________________________________________________<br />

_____________________________________________________________________________________<br />

d. Antigen: _______________________________________________________________________________<br />

1. Was the antigen derived from a human Yes □ No □<br />

If yes, were the IRB approved consent form(s) obtained<br />

Yes □ No □<br />

If yes again, please provide RPN Number:_________________________<br />

e. Antigen characteristics: intact cell □ crude extract □ purified protein □ cell lysate □<br />

purified recombinant preparation □ synthetically prepared □<br />

conjugated to:<br />

______________________________________________________________________<br />

Adjuvant: ____________________________________________________________________________<br />

f. Source of antibody/antiserum/hybridoma: ______________________________________________________<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 5 of 10


<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

Age of immunized subject:______________________________________________________________<br />

Route of immunization ( footpad, intrascapular, intrperitoneal, etc.): ______________________________<br />

Adjuvant: ____________________________________________________________________________<br />

Was antigen conjugated<br />

Yes □ No □<br />

If yes, name conjugate (e.g., BSA, ovlabumin, etc.): ________________________________________<br />

g. Screening Assay_________________________________________________________________________<br />

______________________________________________________________________________________<br />

2. ANTIBODIES (monoclonal):<br />

a. Was the antibody obtained from a human Yes □ No □<br />

If yes, were the IRB approved consent form(s) obtained Yes □ No □<br />

If yes again, please provide RPN Number: __________________________________________________<br />

b. Has the antibody been purified: Yes □ No □ Unknown □<br />

If yes, state method: ___________________________________________________________________<br />

c. Is antibody conjugated Yes □ No □<br />

If yes, name conjugate (e.g., fluorescein, rhodamine, alkaline phosphatase, etc.):<br />

____________________________________________________________________________________<br />

d. Antibody:<br />

Specificity: ___________________________________________________________________________<br />

Cross-reactivity (if any):_________________________________________________________________<br />

Ig Class: __________________________________ Subclass: _________________________________<br />

Light chain: lambda □ kappa □ Unknown □<br />

e. Special properties, characteristics, or use:<br />

Can it be used for:<br />

Western blots Yes □ No □ Unknown □<br />

Immunoprecipitation Yes □ No □ Unknown □<br />

Flow cytometry Yes □ No □ Unknown □<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 6 of 10


<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

Immunocytochemistry Yes □ No □ Unknown □<br />

Is it neutralizing Yes □ No □ Unknown □<br />

Can it bind to both denatured and native protein Yes □ No □ Unknown □<br />

Can it be labeled or radio-labeled without loosing specificity Yes □ No □ Unknown □<br />

f. Recommended titers for use in:<br />

Western blots: __________________________<br />

Radioimmunoassays: _________________________<br />

Immunoprecipitation: _____________________<br />

Elisa: _____________________________________<br />

Flow cytometry: _________________________<br />

Neutralization assays: ________________________<br />

Immunohistochemistry: _______________<br />

3. HYBRIDOMAS:<br />

a. Brief history since origin (important changes in culture conditions or methods, clonal method, if any, whether<br />

antibiotics have been used, current passage number, population doublings (PDLs), etc.):<br />

_____________________________________________________________________________________<br />

_____________________________________________________________________________________<br />

b. Was the hybridoma obtained from a human Yes □ No □<br />

If yes, were the IRB approved consent form(s) obtained Yes □ No □<br />

If yes again, please provide RPN Number: __________________________________________________<br />

c. Hybridoma origin<br />

Species of antibody producing cell: _______________________________________________________<br />

Was immunization conducted in vivo or in vitro _____________________________________________<br />

Fusion partner (designation/strain/species): _________________________________________________<br />

d. Antibody:<br />

Specificity: ___________________________________________________________________________<br />

Cross-reactivity (if any):_________________________________________________________________<br />

Ig Class: _______________________________________ Subclass: ____________________________<br />

Light chain: lambda □ kappa □ Unknown □<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 7 of 10


<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

e. Medium, antibiotics, etc. used in stock transferred to <strong>BEI</strong> <strong>Resources</strong>:________________________________<br />

________________________________________________________________________________________<br />

f. Recommended culture medium and subculture procedure: ________________________________________<br />

______________________________________________________________________________________<br />

g. Recommendations for freezing cells, if any: ____________________________________________________<br />

4. ANTISERUM:<br />

a. Dates of immunization protocol (was antibody from a primary response, secondary, etc.):<br />

_____________________________________________________________________________________<br />

b. Was antisera pooled Yes □ No □ Unknown □<br />

If yes, how many subjects contributed to pool ______________________________________________<br />

c. Has the antibody been purified: Yes □ No □ Unknown □<br />

If yes, state method: ___________________________________________________________________<br />

d. Is antibody in serum conjugated Yes □ No □<br />

If yes, name conjugate (e.g., fluorescein, rhodamine, alkaline phosphatase, etc.):<br />

____________________________________________________________________________________<br />

e. Antibody:<br />

Specificity: ___________________________________________________________________________<br />

Cross-reactivity (if any):_________________________________________________________________<br />

Ig Class: __________________________________ Subclass: _________________________________<br />

Light chain: lambda □ kappa □ Unknown □<br />

f. Special properties, characteristics, or use:<br />

Can it be used for:<br />

Western blots Yes □ No □ Unknown □<br />

Immunoprecipitation Yes □ No □ Unknown □<br />

Flow cytometry Yes □ No □ Unknown □<br />

Immunocytochemistry Yes □ No □ Unknown □<br />

Is it neutralizing Yes □ No □ Unknown □<br />

Can it bind denatured as well as native protein Yes □ No □ Unknown □<br />

Can it be labeled or radiolabeled without loosing specificity Yes □ No □ Unknown □<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 8 of 10


<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

g. Recommended titers for use in:<br />

Western blots: _____________________________ Neutralization assays: _________________________<br />

Immunoprecipitation: ________________________ Radioimmuassays: ___________________________<br />

Flow cytometry: ____________________________ Elisa: _____________________________________<br />

Immunohistochemistry: ______________________<br />

5. FINAL PREPARATION OF MATERIAL AS SUBMITTED TO <strong>BEI</strong>/ATCC<br />

a. Has the Material been tested for mycoplasma contamination: Yes □ No □<br />

If yes, indicate methods and results: ______________________________________________________<br />

___________________________________________________________________________________<br />

b. Identify any reagents of plant/animal origin used in production of this Material (i.e., serum growth factors,<br />

trypsin, etc.) and the manufacturer and country of origin: ______________________________________<br />

____________________________________________________________________________________<br />

____________________________________________________________________________________<br />

c. Describe any other Quality Control tests (biochemical or molecular) and results: ____________________<br />

____________________________________________________________________________________<br />

d. Number of vials being transferred to <strong>BEI</strong> <strong>Resources</strong>: __________________________________________<br />

e. Titer/concentration per vial: _____________________________________________________________<br />

f. Type of vial in which antibody will be provided:<br />

____________________________________________________________________________________<br />

g. Label designation on vials being transferred to <strong>BEI</strong> <strong>Resources</strong>:<br />

________________________________________________<br />

6. PRESERVATION/SHIPPING CONDITIONS<br />

a. Recommended storage conditions (temp., etc.) __________________________________________________<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 9 of 10


<strong>DEPOSIT</strong> <strong><strong>FOR</strong>M</strong> – Part 2 of 2<br />

ANTIBODIES, HYBRIDOMAS & ANTISERA<br />

b. Recommended shipping conditions: ________________________________________________________<br />

____________________________________________________________________________________<br />

c. Special handling conditions required: ________________________________________________________<br />

_____________________________________________________________________________________<br />

7. SAFETY AND REGULATORY IN<strong><strong>FOR</strong>M</strong>ATION<br />

a. Does this antibody preparation contain material hazardous to: Humans______ Animals ______ Plants<br />

If so, what is the Biosafety Level (BSL) required to handle it (refer to Biosafety in Microbiological and Biomedical<br />

Laboratories, 4 th ed. HHS Publications No. (CDC) 93-8395 U.S. Department of Health and Human Services. The complete text is available<br />

atww.cdc.gov/od/ohs/biosfty/bmbl4toc.htm):<br />

__________________________________________________________________________________<br />

b. Has the Material been screened for the presence of contaminating pathogens If<br />

Yes, please specify test and results: ________________________________________<br />

c. Is the Material in solution Yes □ No □<br />

d. Does the Material require special permits Yes □ No □<br />

If yes, please specify: _________________________________________________________________<br />

e. Is this antibody specific for a material listed on the U.S. Government’s Select Agent list Yes □ No □<br />

f. List any routine vaccines or surveillance provided to investigators handling this Agent.<br />

________________________________________________________________________________________<br />

g. Is the Material radioactive Yes □ No □<br />

If yes, specify isotope, chemical composition, total radioactivity per vial and date radioactivity was measured.<br />

_________________________________________________________________________________________<br />

_________________________________________________________________________________________<br />

Biodefense and Emerging Infections Research <strong>Resources</strong> Repository 800-359-7370<br />

P.O. Box 4137 Fax: 703-365-2898<br />

Manassas, VA 20108-4137 USA<br />

E-mail: contact@beiresources.org<br />

www.beiresources.org Effective Date: 09/04/2007<br />

Revision: 1<br />

© 2004 American Type Culture Collection (ATCC). All rights reserved. Document ID: 4388<br />

Page 10 of 10

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!