2001-00234 Grant 306 - Laserfiche WebLink

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Instructions for ED 424 1. Legal Name and Address. Enter the legal name of appli- check "Yes." If all the research activities are designated to cant and the name of the primary organizational unit which be exempt under the regulations, enter, in item 12a, the ex- will undertake the assistance activity. emption number(s) corresponding to one or more of the six exemption categories listed in "Protection of Human Sub - 2. D -U -N -S Number. Enter the applicant's D -U -N -S Number. jects in Research" attached to this form. Provide sufficient If your organization does not have a D -U -N -S Number, you information in the application to allow a determination that can obtain the number by calling 1- 800 - 333 -0505 or by the designated exemptions in item 12a, are appropriate. completing a D -U -N -S Number Request Form. The form Provide this narrative information in an "Item can be obtained via the Internet at the following URL: 12/Protection of Human Subjects Attachment" and in- http: / /www.dnb .com/dbis /aboutdb /intlduns.htm. sert this attachment immediately following the ED 424 face page. Skip the remaining parts of item 12. 3. Tax Identification Number. Enter the tax identification number as assigned by the Internal Revenue Service. If some or all of the planned research activities involving human subjects are covered (nonexempt), skip item 12a and 4. Catalog of Federal Domestic Assistance (CFDA) Num- continue with the remaining parts of item 12, as noted be- ber. Enter the CFDA number and title of the program under low. In addition, follow the instructions in "Protection of which assistance is requested. Human Subjects in Research" attached to this form to prepare the six -point narrative about the nonexempt activi- 5. Project Director. Name, address, telephone and fax num- ties. Provide this six -point narrative in an "Item bers, and e-mail address of the person to be contacted on 12/Protection of Human Subjects Attachment" and in- matters involving this application. sert this attachment immediately following the ED 424 face page. 6. Federal Debt Delinquency. Check "Yes" if the applicant's organization is delinquent on any Federal debt. (This ques- If the applicant organization has an approved Multiple tion refers to the applicant's organization and not to the per- Project Assurance of Compliance on file with the Grants son who signs as the authorized representative. Categories Policy and Oversight Staff (GPOS), U.S. Department of of debt include delinquent audit disallowances, loans and Education, or with the Office for Protection from Research taxes.) Otherwise, check "No." Risks (OPRR), National Institutes of Health, U.S. Depart- ment of Health and Human Services, that covers the specific 7. Type of Applicant. Enter the appropriate letter in the box activity, enter the Assurance number in item 12b and the provided. date of approval by the Institutional Review Board (IRB) of the proposed activities in item 12c. This date must be no 8. Novice Applicant. Check "Yes" only if assistance is being earlier than one year before the receipt date for which the requested under a program that gives special consideration application is submitted and must include the four (4) digit to novice applicants and you meet the program requirements year (e.g., 2000). Check the type of IRB review in the ap- for novice applicants. By checking "Yes" the applicant cer- propriate box. An IRB may use the expedited review pro- titles that it meets the novice applicant requirements speci- cedure if it complies with the requirements of 34 CFR fled by ED. Otherwise, check "No." 97.110. If the IRB review is delayed beyond the submission of the application, enter "Pending" in item 12c. If your ap- 9. Type of Submission. Self - explanatory. plication is recommended/selected for funding, a follow -up certification of IRB approval from an official signing for the 10. Executive Order 12372. Check "Yes" if the application applicant organization must be sent to and received by the is subject to review by Executive Order 12372. Also, please designated ED official within 30 days after a specific formal enter the month, date, and four (4) digit year (e.g., request from the designated ED official. If the applicant 12/12/2000). Applicants should contact the State Single organization does not have on file with GPOS or OPRR an Point of Contact (SPOC) for Federal Executive Order 12372 approved Assurance of Compliance that covers the pro - to determine whether the application is subject to the State posed research activity, enter "None" in item 12b and skip intergovernmental review process. Otherwise, check "No." 12c. In this case, the applicant organization, by the signa- ture on the application, is declaring that it will comply with 11. Proposed Project Dates. Please enter the month, date, and 34 CFR 97 within 30 days after a specific formal request four (4) digit year (e.g., 12/12/2000). from the designated ED official for the Assurance(s) and IRB certifications. 12. Human Subjects. Check "Yes" or "No ". If research activities involving human subjects are not planned at any 13. Project Title. Enter a brief descriptive title of the project. time during the proposed project period, check "No." The If more than one program is involved, you should append an remaining parts of item 12 are then not applicable. explanation on a separate sheet. If appropriate (e.g., con- struction or real property projects), attach a map showing If research activities involving human subjects, whether or project location. For preapplications, use a separate sheet to not exempt from Federal regulations for the protection of provide a summary description of this project. human subjects, are planned at anv time during the pro- posed project period, either at the applicant organization or 14. Estimated Funding. Amount requested or to be contributed at any other performance site or collaborating institution, during the first funding/budget period by each contributor.