Montana State University Transfre of Excluded Select Toxins is in accordance with 42 CFR § 73.

 denotes required fields.

The person who will receive and be responsible for the toxin.
Toxin name, amount to be transferred, and date of expected transfer
What is the proposed use of this toxin? Also, describe facilities/biosafety procedures and any relevant Biosafety protocols that have been approved by your Institutional Biosafety Committee.
I certify that this toxin will be used in accordance with 42 CFR 73 and I have a legitimate need (i.e., reasonably justified by a prophylactic, protective, bon fide research, or other peaceful purpose) to handle or use such toxin.