Requesting Investigator *

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Laboratory Principal Investigator *

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Phone Number *

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FedEx Mailing Address *

Address 1

Address 2

City

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Lines Requested *

Check all that apply

rag2 E450fs (AB)

rag2 E450fs (Casper)

jak3 P369fs (Casper)

prkdc D3612fs (Casper)

il2rga Y91fs (Casper)

il2grb I30fs (Casper)

zap70 Y442fs (Casper)

prkdc D3612fs, il2rga Y91fs (Casper)

nk-lysin 1-4 KO

rag2 knockout (Casper)

CG1 tp53^fb105/fb105

rag2-deletion, il2rga Y91fs (Casper)

MTA *

A universal MTA is required for transfer of these animals. This MTA states that lines will not be shared with for-profit institutions and that these lines will not be commercialized for profit. Please find and download the MTA form below and return by email or fax to: Alina Bica-Huiu, JD Partners Innovation 399 Revolution Drive, Suite 755 Somerville, MA 02145 (857) 282-1803 ABICA-HUIU@MGB.ORG

I understand and agree to these requirements.