【Sample of Form M-11C】(Form M-11C-1)

RIKEN BRC

・ Obtain the latest version of the form file from theJCM website to prepare the document.
FillAGREEMENTin Recipient Scientist (must be a PrincipalMATERIAL
・Use Adobe Acrobat or Reader
to prepare the TRANSFERInvestigator)
name, official name and address
document (do not use third-party
PDF
editingtools).
(ForUsefor For-Profit
ResearchPurpose)of Recipient Organization (including department)
without using abbreviation.

RECIPIENT

Recipient Scientist (Principal Investigator): Ichiro Riken
Recipient Organization: Department of Microbiology, Riken University
Address:

3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074 Japan

This Material Transfer Agreement sets forth the terms and conditions under which RIKEN BioResource
Research Center (hereinafter referred to as ‘RIKEN BRC’) will provide with the RECIPIENT, and theRECIPIENT will receive, the biological material specified asCampylobacter rectus, Campylobacter lari subsp. lari, Noviherbaspirillum malthae(JCM No. 6301, 6302, 14870, 18414)

Fill in the latest Scientific name and JCM No. for each strain.
and its derivatives (hereinafter referred toAttachas thean‘BIOLOGICALRESOURCE’)in responseto theextra sheet entitled“Attachmentfor MATERIAL
TRANSFER
AGREEMENT”
ifthespaceisnotenough.
RECIPIENT’s request, and with which the RECIPIENT scientist and organization agree before theRECIPIENT receives the BIOLOGICAL RESOURCE:
1.

The RIKEN BRC, a non-profit public organization financed by the Japanese Government, isengaged in collection, maintenance, storage, propagation, quality control and distribution of thebiological resources, in order to contribute to the Japanese and international scientific community
in the field of life sciences.

2.

(a) The RECIPIENT shall use the BIOLOGICAL RESOURCE for the following specific purpose:

Fill in research purpose (objectives/aims/goals of the research) in detail.
Write specific how and for what purpose you are going to use JCM strain(s).

(b) The RECIPIENT shall obtain a written prior permission from the RIKEN BRC for the usageof the BIOLOGICAL RESOURCE for any other purposes than the purpose specified above.
3.

The RECIPIENT shall not use the BIOLOGICAL RESOURCE for diagnosis or treatment ofhumans or other direct applications to human bodies or as food source for humans.

4.

The RECIPIENT agrees to use the BIOLOGICAL RESOURCE complying with the following
specific terms and conditions set forth by the DEPOSITOR, which are listed in the RIKEN BRC
Catalog and/or Website: Terms and conditions for distribution of strain JCM ◯◯◯The following specific terms and conditions are requested by the DEPOSITOR:
In publishing the research results obtained by use of the BIOLOGICAL RESOURCE, citation of the following literaturedesignated by the DEPOSITOR is requested: Int. J. Syst. Evol. Microbiol. 00:1234-1240 (DOI: □□/□□□□)Refer to the table displayed in the lower part of the JCM On-line Catalogue for each strain.
Terms and conditions

Not applicable

Terms and conditions

Imposed–： Fill in “N/A”.

(2021-04-08)：Click the [information] button, then fill in the wholesentences displayed.
(or print out the webpage as an attachment)(Form M-11C-4)
The RECIPIENT and the RIKEN BRC do hereby sign two original copies of this AGREEMENT andeach party holds one signed copy.

RIKEN BioResource Research Center
3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074 Japan
DirectorToshihiko Shiroishi, Ph.D.
Signature:
Date:“Authorized Representative” should be a person
authorized to sign on behalf of the organization.

RECIPIENT
Organization:
Address:

・President of Company
・Dean of University / College / School / Faculty・Head of Intellectual Property Management Division

Name of Authorized Representative: Name of Dean, Director or President
Job Title:
Signature:
Date:
Name of Scientist (Principal Investigator):

Recipient (No student or trainee)

Job Title:
Signature:"Scientist" should be aPrincipal Investigator.

Date:

RIKEN BRC-JCM(Reception Date）(Reception No.

）(MTA No.

）(2021-05-07)