Material Deposit Form, Definitions and
Terms and Condition for Material Deposit Agreement (MDA)
for the deposit of material in the public collection
DBVPG Industrial Yeasts Collection

TO:
INDUSTRIAL YEASTS COLLECTION – DBVPG
Department of Agricultural, Food and Environmental Sciences
University of Perugia
Borgo XX Giugno, 74
I 06121 Perugia – Italy

    Part I – Deposit Form

    A. General


    Is the MATERIAL a type strain?



    Has a sexual cycle been observed for this strain?


    B. Information on provenance of the MATERIAL, relating to the Convention on Biological Diversity (CBD – www.cbd.int/) and Nagoya Protocol on Access and Benefit Sharing (ABS), and other applicable legal requirements for access to the MATERIAL
    In order to assure compliance with all legal and regulatory requirements any information which is relevant has to be provided to and assessed and stored by the COLLECTION. Please provide as much detail as possible on the geographical origin, and terms and conditions for use of the MATERIAL as laid down in relevant documents covering the MATERIAL, including material transfer agreements (MTA), prior informed consent (PIC), mutually agreed terms (MAT) or other documents such as collecting- or export permits of landowners etc. – Be aware that if information provided is insufficient to determine whether MATERIAL is in or out of scope of ABS legislation or regulatory requirements, the DBVPG may have to refuse the MATERIAL.
    B.1 Geographic origin and sampling


    Country of origin is not applicable, because:



    If the MATERIAL originates from an area beyond national jurisdiction (e.g. the High sea, area covered by the Antarctic Treaty), provide the geographic location as precisely as possible and, if collected on High sea, the name of the vessel.



    B.2 Documents providing evidence of legal access in the Country of Origin and providing terms for use of the MATERIAL







    Name and address/website:

    Copies of documents settling details of any agreed benefit sharing arrangements or other form of agreements between initial provider and recipient (you, or person or persons before you) of the strain will be needed.
    Reference, document(s) identifier(s):

    C. Isolation and identification of the strain



    If you did not isolate the strain, please indicate scientists and laboratories which maintained it before you:



    D. Hazardous Properties
    Risk Group assignment:


    Biological Safety Level recommended for containment:
    E. Others Information

    F. Conditions for use of the MATERIAL by the COLLECTION and THIRD PARTIES




    Part II – Definitions and Terms and Condition for the deposit in the public collection

    1. Definitions
    2. Terms and Condition

    Name of the Depositor and position in the Institution:

    Contact name (only for legal entity)

    E-mail *

    Phone

    Institution Name

    Address

    VAT

    Website

    SDI code and PEC2

    First and last name of the head of the depositor institution

    Position

    Date and Place of signature

    Signature of the head of the depositor institution

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