Strain Deposit Request and Agreement Form
Date:
Depositor's full name with family name in capitals:
Depositor's affiliation and address:

Tel.:
Fax:
E-mail:I wish to deposit the following microbial culture strain in the NIES-Collection.
[Reason for deposit][Basic information]
Scientific name with author name(s):Division:
Class:
Order:
Family:Synonym:
Identified by (full name with family name in capitals):
Identification year:
Strain designation or code:
Other collection name and number (If the depositor has deposited the same strain in other collections):[Collection]
Collection date:
Collector's name (full name with family name in capitals):
Site information
Latitude and longitude as GPS or WGS-84 geographic coordinates:
Country:
Address (most detailed one):
Place name (e.g. name of river, lake, pond, bay and coast):
Ocean name and nearest country to site:
Habitat: □marine □freshwater □brackish (salinity:‰) □terrestrial □salt water □hot spring□cold spring □snow □ice □others ()Details of habitats: □oligotrophic □mesotrophic □eutrophic □dystrophic □surface□depth in chlorophyll max □other depth (– m) □other ()Details of marine environment: □coastal □pelagic □tidal pool □tidal flat □mangrove □estuary□harbor □other ()Details of freshwater environment: □lake □pond □reservoir □river □stream □ditch □wetland□rice field □other ()Details of terrestrial environment: □farm land □forest floor □bark □stone wall □other()
Other information or comments on the habitat:[Isolation]
Date of isolation:
Isolator's name (full name with family name in capitals):
Source of isolation: □water □seawater □sand □sediment □soil □lichen □plant □seaweed□seagrass□coral □sponge □other animals () □snow □ice
□other ()Isolation objective: □motile vegetative cell □non-motile vegetative cell □spore□tetraspore□carpospore □zygote □parthenogenetic gamete □thallus □other ()Isolation method: □single-cell isolation by pipette washing □cut-out of specimen □dilution □single
colony isolation by agar plating □taxis □flow cytometry with cell sorter □other ()Notes on isolation conditions (e.g. medium, light, temperature, if different from maintenance conditions):
Treatment at isolation: □none □antibiotics (name:mg/L) □other chemicals (name:(GeO2)(radiation □after cyst germination □other (,,mgL) □germanium dioxidemg/L) □ultra-sonic wave □UV)

[Strain status]
Algae and cyanobacteria: 1) □unialgal or □mixed2) □clonal or □non-clonal3) □axenic, □non-axenic or □non-axenic required
Protozoa:□axenic , □non-axenic or □non-axenic required or □monoxenic (or □mixed
Date of bacteria-free check:[Preservation conditions]
Medium name:
Reference for medium:
Medium phase: □liquid □semi-solid
Notes for preparation of medium:as food)□solid □soil water biphasic

Sub-culturing conditions
Temperature:°C (pre-culture temperature if needed,°C)
lux (preculture light intensity if neededµmol m–2 s–1, orLight intensity:µmol m–2 s–1, orlux)
Light source: □LED lamps □white fluorescent lamps □daylight fluorescent lamps □natural light□other ()Light–Dark cycle: □12 h/ 12 h □others ( h/ h)Interval of transfer:days ormonth(s) (pre-culture duration if needed,days)
Culture vessel: □test tube □Erlenmeyer flask □plastic culture flask □other ()Additional notes on culture conditions (e.g. information for optimal growth conditions, transfer methods,quantity of cells to transfer:
Remarks on how to recover a good growth when strain state is bad:Cryopreservation: □yes □no □unknown
Cryoprotectant:(concentration:%)Cryopreserved in: □vapor-phase liquid nitrogen □liquid-phase liquid nitrogen □–80°C freezer□other ()Methods: □two step cooling (cool until°C at a rate of°C/min, hold at °C formin,and plunge into liquid N2)□other methods: ()Special notice for incubation just after thawing (e.g. darkness, dim light):
References for methods:
Notes and comments on cryopreservation:
Freeze-drying: □yes □no □unknown
Method:Reference for method:
L-drying: □yes □no □unknown
Method:Reference for method:[Characteristics]- 2 -Environmental characteristics□red tide □water bloom □toxic □predator of water bloom–forming species□offensive taste □offensive odor □filter and screen clogging □decomposes hazardous substances□AGP (algal growth potential) test □bioindicator□other ()Physiological and ecological characteristics□autotrophic □heterotrophic □mixotrophic □phagotrophic □auxotrophic (requires□mutant (which kind?;□nitrogen-fixing□planktonic □benthic □endophytic □periphytic (□epiphytic □epilithic □other (□symbiotic □parasitic□thermophilic □cryophilic □halophilic □acidophilic □xerophilic□phototaxic □chromatic adaptation □bioluminescence□hydrogen-evolving □oil (hydrocarbon) -producing □high CO2-fixing□cosmopolitan □endemic to (country/area name:)□other ()Miscellaneous characteristics□type strain (or authentic strain if eukaryotic)□taxonomically (evolutionarily, phylogenetically) important(details:□heterothallic □homothallic □dioecious □monoecious□isogamous □anisogamous □oogamous□mating type(＋) □mating type(–) □female □male□life cycle known(details:□life cycle unknown□resting spore–forming□other ()))))))

References for these characteristics reported using the deposited strain:[Genetic information (please write down all registered data)]
Accession no. (with gene name and registration date):
Registrant (full name with family name in capitals):[References]
Publications in which the strains were used (please make a reference list according to the example below)(Example) Otsuka, S., Suda, S., Shibata, S., Oyaizu, H., Matsumoto, S., Watanabe, M. M. 2001. A
proposal for the unification of five species of the cyanobacterial genus Microcystis Kützing ex
Lemmermann 1907 under the rules of the Bacteriological Code. Int. J. Syst. Evol. Microbiol., 51,873–879.

Other references relevant to the strain(s) (e.g. references used for identification; please make a reference listaccording to the example above)[Patents and other intellectual properties] □yes□no[Any other remarks and comments]

Agreement for deposition
1. The depositor shall deposit the strain in the NIES-Collection without charge. The transfer of intellectual- 3 -properties is not included in the agreement. The NIES-Collection may maintain and culture the strain(including DNA) and distribute it to users.
2. The depositor shall submit accurate strain data to the NIES-Collection; these data shall include patents,
properties and states of the strain.
3. The strain shall be free from any limitation, legally and contractually, pursuant to one of the following
reasons (please tick):□ The strain was isolated/developed by the depositor.
□ The strain is deposited with the permission of the isolator/developer/collaborator of the original
country (if collected in a foreign country).
□ The strain has been purchased without any limitation regarding the deposit thereof, and with thepermission of the original collection.
4. The NIES-Collection may distribute the deposited strains to users in accordance with the following
condition (please tick):□ The strain shall not be disclosed to the public until the paper regarding the strain has been published□ Other reason ()This condition will last no longer than 1 year, and the strain will be open to the public even if thedepositor imposes conditions. If the depositor does not specify any conditions, then the strain will be
open to the public immediately after approval by the Committee for Evaluating Microbial Culture
Strains.
5. The NIES-Collection shall bear no responsibility for inevitable change and loss during maintenance, orfor loss caused by natural disasters.
6. The NIES-Collection may stop the maintenance and distribution of the strain in accordance with adecision made by the Committee for Evaluating Microbial Culture Strains.

The NIES-Collection (the Collection) and the depositor make two copies of the agreement; the Collection
and the depositor each hold one.
We, the NIES-Collection (the Collection) and the depositor, accept the above conditions in order to transfer
the strain(s).
<<Collection>>
Organization: Microbial Culture Collection,
Biodiversity Resource Conservation Office,Biodiversity Division,
National Institute for Environmental Studies
Address: 16-2, Onogawa, Tsukuba, Ibaraki 305-8506, Japan
Director:
Signature:
Date:<<Depositor>>
Organization:Address:
Name of depositor (with title):
Signature:Date:- 4 -