Application to creategenetically modifiedN° ......
animals (GM)using recognized methods[leave empty]
(simplified authorization procedure)

Art. 11 Animal Welfare Act (TSchG), Art. 142 Animal Welfare Ordinance (TSchV),
Annex 1 to Animal Experiments Ordinance (TVV)

Type of application / New application / Renewal/
continuation
of no.: / Addendum
to no.:
A.Cantonal authority
Name,
Address
B.Details of laboratory animal husbandry
B1
Head of laboratory animal husbandry
Surname, first name
address, e-mail, phone
B2
Licence number of laboratory animal husbandry
B3
Location of animal husbandry
Address
C.Purpose of creating animals, species of animal, method and procedure
C1
Purpose of creation
(Art. 8 GTG,
Art. 138 para. 2 TSchV) /
The integrity of the animalsshall not be disregarded through the manipulation of the genome by genetic engineering (article 8 GTG, law on the application of genetic engineering in non human context, SR 814.91).
C2
Animal species
Name
further comments (origin, etc.)
C3
Recognised methods of creating GM
(Annex 1 TVV) / Crossing of genetically modified lines
Pronuclear injection in mouse, rat, rabbit or guinea pig
Injection and aggregation of embryonic stem cells in mouse or rat
Use of viral vectors in mouse or rat
Intracytoplasmic sperm injection in the mouse
Injection into the cytoplasm or the yolk sac of early embryonic stages (1 to 16-cell stage) in zebrafish
Remarks:
C4
Procedure
  • Description of procedures: process, manipulations, anaesthesia, analgesia
  • SOP
  • Monitoring, criteria for euthanasia
  • Location of procedure
  • References to literature or databases
(Art. 128, 135 TSchV) / Documents on creating GM enclosed
C5
Record of constraint
(Art. 124 TSchV, Art.12–16 and 1921 TVV) / Documents on monitoring of constraint enclosed
C6
Genotyping and marking
  • Sampling
  • Marking
(Art. 10 TVV) / Combined genotyping / marking: yes no
C7
Methods of phenotyping
  • Behaviour tests (SOP)
  • Sampling
    (if necessary)
(Art. 11 TVV)
D.Persons
Function
(HM, Dep HM, SD, Dep SD, EXP)1 / Surname, first name / Performs the following procedures2 / Enclosures sent to authorities
(insert letters A or B)3
1HM= husbandry manager; Dep HM = deputy husbandry manager; SD = study director;
Dep SD = deputy study director, EXP = experimenter
2Column to be completed in abbreviated form, e.g. amputation of toe tips, implantation of embryos in foster mice, etc.
3The above persons must show that they satisfy the requirements with regard to their qualifications and further training
(Art. 115, 132, 134, 190, 195 TSchV).
  1. Persons who are not yet registered with the cantonal authority must furnish evidence of qualifications and further training (incl. curriculum).
  2. Persons who are already registeredmust enclose evidence of further training completed per 4 year period.

E.Signatures
The undersigned Study Director confirms that the information given is complete and correct:
Date: ...... Name and signature: ......
The undersigned Husbandry manager(Art. 114 TSchV) confirms that the responsibilities for looking after and monitoring the animals during production and breeding of the animals are settled (Art. 131 c TSchV):
Date: ...... Name and signature: ......

Enclosures:

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