Number used Species/Strain Location1/Institution Total number Total number used in during this to endnotes for the approved for project project (Common name) reporting period correct location code) Any additional information or comments can be entered below. If there were major discrepancies between the number of animals approved and the number used you must provide an explanation below: Please provide any overall comments, suggestions or recommendations in respect of the use of and/or welfare of animals, based on your observations and experience from this project, below: DECLARATION I declare that to the best of my knowledge, the information contained in this report is complete and correct. RESPONSIBLE INVESTIGATOR OR NOMINEE Name of Investigator or Nominee: Signature: Date: DECLARATION FOR STUDENTS (Final Year) Declaration for students involved in a teaching project involving live animals when (To allow for signatures, this form may be printed, scanned and submitted with your application) Animal Ethics Committee approval number: Responsible investigator: Please sign to certify the following: I am familiar and will comply with all relevant Commonwealth and State or Territory legislation and the requirements of the Australian Code for the Care and Use of Animals for Scientific Purposes 8th Edition 2013. I accept that I have a responsibility to ensure that the investigations and procedures proposed in this form are conducted fully within the conditions laid down by the Code and I undertake not to use any animals or carry out any procedures which have not been approved by the Committee. I accept that the responsible investigator has ultimate responsibility for the project. Full Name Signature Date
Species/Strain (Common name) Total number approved for project Number used during this reporting period Total number used in project Location1/Institution to endnotes for the correct location code) Any additional information or comments can be entered below. If there were major discrepancies between the number of animals approved and the number used you must provide an explanation below: Please provide any overall comments, suggestions or recommendations in respect of the use of and/or welfare of animals, based on your observations and experience from this project, below: DECLARATION I declare that to the best of my knowledge, the information contained in this report is complete and correct. RESPONSIBLE INVESTIGATOR OR NOMINEE Name of Investigator or Nominee: Signature: Date: DECLARATION FOR STUDENTS (Final Year) Declaration for students involved in a teaching project involving live animals when (To allow for signatures, this form may be printed, scanned and submitted with your application) Animal Ethics Committee approval number: Responsible investigator: Please sign to certify the following: I am familiar and will comply with all relevant Commonwealth and State or Territory legislation and the requirements of the Australian Code for the Care and Use of Animals for Scientific Purposes 8th Edition 2013. I accept that I have a responsibility to ensure that the investigations and procedures proposed in this form are conducted fully within the conditions laid down by the Code and I undertake not to use any animals or carry out any procedures which have not been approved by the Committee. I accept that the responsible investigator has ultimate responsibility for the project. Full Name Signature Date
Reporting-form-August-2016.-21.docx