MVLS Material Transfer Agreement (MTA) Questionnaire

The purpose of this form is to provide the necessary background information to expedite the review of the MTA terms/conditions associated with access and use of any third party Material. This information will help us to ensure that any third party requirements both complement and preserve your current and future research interests, while ensuring full compliance with funder terms. To facilitate matters please complete the brief questionnaire below.

  1. PI/Project Details

Name: / Enter PI name /
Email: / Enter email address
School/Institute: / Please select /
Tel No: / Enter extension/external line /
Date: / Enter date of submission (today)
Organisation providing material: / Enter name of organisation /
Project Name: / Enter name of Research Project
Funder Name: / Enter name of Funder(s) /
Award Letter: / If available, please embed here* /

*To embed document Insert, Object, Create from File, ensure Display as Icon has been checked, Browse and select document on system.

  1. Additional Information
a) Please provide a brief description of the Material requested.

  1. Additional Details

b) Please provide a brief description of how this Material will be used

c)Is this Material or suitable alternative freely available in the public domain or accessible from another source?

YesNoNot sure

If ‘yes’, please expand on alternative sources and why this provider is preferred.

Please provide sufficient detail to allow us to assess the value of the Materials and the fairness of the MTA terms

d)Are you aware if there are any existing patents associated with this Material or other alternative sources?

Yes patentsNo patentsNot sure

3.Third Party Obligations

a) Please indicate how the purchase of this Material is being funded?

Internally-funded research programme

Non-commercially funded research programme

Commercially-funded research programme

If either the ‘Non-commercially-funded’/’Commercially-funded’ box is checked please provide details of the funding organisation(s) supporting this research:

Where there is Funder involvement, we will need to consult the terms and conditions to ensure that there are no conflicts. If available, please provide a copy of the Award Letter, as requested above. If you are aware of any potential conflicts, please provide details. /

b)Will your intended use of this Material result in its incorporation into your pre-existing intellectual property/know-how?

4. If the MTA terms/conditions governing the use of this Material place any restriction of your research outputs i.e. access/use of the results, publication, and/or potential exploitation/commercialisation, will this present any issues or impact on your current/future research activities?

YesNoNot sure

Please expand briefly on your above selection choice.

Please note that MTAs often include terms such as a prohibition against use for commercial purposes, a prohibition on transfers to any third parties and include obligations to redact, remove or anonymise certain information in publications. Please note that these restrictions may apply to unmodified derivatives, modifications and progeny. /

4a. Will any students be working with this material?

YesNoNot sure

4b.If 'yes', is an assignation agreement in place to cover the student's results of this research?

YesNoNot sure

4c. If ‘no’, please complete attached Assignation Questionnaire to allow us to generate an agreement.

5. Are there any third party providers who are also involved, or could become involved, in the Research Project?

6. If access to this Material is considered important to your on-going research activities please provide a brief statement indicating why?

Please provide details such as anticipated results, potential intellectual property generated, relationship benefits. /