---------------------------------------------------- -----------------------------------
  **CURATORIAL FORM F-75**                             PARENT SAMPLE
                                                       \_\_\_\_\_\_\_\_\_\_\_,\_\_\_\_\_

  **RETURN SAMPLE ACCOUNTABILITY & HISTORY**           PAGE \_\_\_\_\_\_\_\_\_\_ OF
                                                       \_\_\_\_\_\_\_\_\_\_
  ---------------------------------------------------- -----------------------------------

Please complete one form for each sample on your inventory listing that
you are returning. Use Form F-75, Continuation Sheets to document any
subsamples that you have created from this sample. In the comments
blocks, describe the history of contamination that each sample has
experienced. Refer to the instructions for returning samples for more
complete details.

+-------------------+---+------------------------+-------------------+
| **A. INFORMATION  |   |                        |                   |
| PROVIDED BY       |   |                        |                   |
| SAMPLE            |   |                        |                   |
| INVESTIGATOR**    |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| **Item**          | * | 9\.                    |                   |
|                   | * | History/Contamination  |                   |
|                   | M | & PI Comments          |                   |
|                   | a |                        |                   |
|                   | s |                        |                   |
|                   | s |                        |                   |
|                   | ( |                        |                   |
|                   | g |                        |                   |
|                   | ) |                        |                   |
|                   | * |                        |                   |
|                   | * |                        |                   |
+-------------------+---+------------------------+-------------------+
| 1\. Mass of       |   |                        |                   |
| Sample as Issued  |   |                        |                   |
| by Sender         |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| \_\_\_\_\         |   |                        |                   |
| _\_\_\_\_\_\_\_\_ |   |                        |                   |
| \_\_\_\_\_\_\_\_\ |   |                        |                   |
| _\_\_\_\_\_\_\_\_ |   |                        |                   |
| \_\_\_\_\_\_\_\_\ |   |                        |                   |
| _\_\_\_\_\_\_\_\_ |   |                        |                   |
| \_\_\_\_\_\_\_\_\ |   |                        |                   |
| _\_\_\_\_\_\_\_\_ |   |                        |                   |
|                   |   |                        |                   |
| Name of Sender    |   |                        |                   |
| (If not Curator)  |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 2\. Mass of       |   |                        |                   |
| Sample as         |   |                        |                   |
| Measured by You   |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 3\. Total of      |   |                        |                   |
| Sample Mass       |   |                        |                   |
| Consumed          |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 4\. Sample Mass   |   |                        |                   |
| Previously        |   |                        |                   |
| Returned to       |   |                        |                   |
| Curator           |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 5\. Total         |   |                        |                   |
| Sample/Residue    |   |                        |                   |
| Mass Retained     |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 6\. Sample Mass   |   |                        |                   |
| Transferred to    |   |                        |                   |
| Other PI\'s       |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 7\. Total Sample  |   |                        |                   |
| Mass Returned to  |   |                        |                   |
| Curator           |   |                        |                   |
+-------------------+---+------------------------+-------------------+
| 8\. Mass % of     | \ |                        |                   |
| Admixed Material  | % |                        |                   |
+-------------------+---+------------------------+-------------------+
| 9\. Sample Mass   |   |                        | \                 |
| Not Accounted For |   |                        | _\_\_\_\_\_\_\_\_ |
|                   |   |                        | \_\_\_\_\_\_\_\_\ |
|                   |   |                        | _\_\_\_\_\_\_\_\_ |
|                   |   |                        | \_\_\_\_\_\_\_\_\ |
|                   |   |                        | _\_\_\_\_\_\_\_\_ |
|                   |   |                        | \_\_\_\_\_\_\_\_\ |
|                   |   |                        | _\_\_\_\_\_\_\_\_ |
|                   |   |                        |                   |
|                   |   |                        | PI Signature      |
+-------------------+---+------------------------+-------------------+

  -------------- ------- ----------- ----------- -- ------------------------ -------- -- -------------------------------------------------------------------------------------- --------
  **B. FOR USE                                                                                                                                                                  
  BY SAMPLE                                                                                                                                                                     
  CURATOR ONLY**                                                                                                                                                                

  **PARENT                                          **WEIGHT BALANCE                     CO Number                                                                              
  SAMPLE                                            ACCOUNTING**                                                                                                                
  PROCESSING**                                                                                                                                                                  

  **Inventory            **Item**    **Mass         **Item**                 **Mass      Processor                                                                              
  Data**                             (g)**                                   (g)**                                                                                              

  Sample \#              Gross                      Issue                                Date Processed                                                                         

  Container              Container                  Transferred to Other                                                                                                        
                                                    PI\'s                                                                                                                       

  Description            Dunnage                    Previously Returned                                                                                                         

  Flags                  Sample                     Current Inventory                    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_   

  Location               Bagged                     Total Return (current)               Curatorial Representative                                                              

                                                    Retained by PI                                                                                                              

  Container                                         CONSUMED                             \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                             
  Sample                                                                                                                                                                        
  Returned In                                                                                                                                                                   

  Sample                 Air Error:  GN2 Error:     (Split #)                            Date                                                                                   
  Rebagged In            Reference   Reference      \_\_\_\_\_\_\_\_\_\_\_                                                                                                      
                         source not  source not                                                                                                                                 
                         found       found                                                                                                                                      

  **PROCESSOR                                                                                                                                                                   
  COMMENTS:**                                                                                                                                                                   

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                

                                                                                                                                                                                
  -------------- ------- ----------- ----------- -- ------------------------ -------- -- -------------------------------------------------------------------------------------- --------

JSC Form 1609 (Rev Jan 97)