1
OKLAHOMA STATE UNIVERSITY Routing Sheet Date Requires Official Signature Requires Notarization Requires Other Signature # to be signed DATE NEEDED BY Who Routing Action Part 1 Source of Funding Flow-Thru Funding Source Primary Routing # Other Routing #'s COA/FC # Project # CFDA # Amount Requested Amount Awarded Project Title Sponsor Name Reference # Begin Date Part 2 Financial Information (Attach documentation as necessary.) VPR Cost Share Form Waived F&A Documentation Cost Share Details/ Documentation If "yes", % allowed: Is recovery of F&A limited: % Amt & % F&A WAIVED $ % Amt & % F&A RECEIVED $ If "yes", $ Is Subcontractor(s) requested: OSU $ Sponsor $ Equipment budgeted: If "yes", $: Other F&A exempt costs: Are there CAS exceptions: GRA Tuition: If "yes", what % Required? COST SHARE: If "yes", $: Third Party Cost Share: If "yes", attach required form. VPR Cost Share REQUESTED TOTAL COST SHARE: Sponsor Waived F&A: F&A on Direct Cost Share: Total Direct Cost Share: Cost Share FOAPAL # (s): Part 3 Compliance Information (PI must complete all applicable questions.) IRB # Expires on Yes No Expires on IBC# Address Approved Where Are space alterations requested? STTR SBIR Neither Is this an SBIR/STTR project: Has Conf. Agreement/NDA been signed? Date Signed: Yes Pending No Has an MTA been signed? Do you or will you have foreign nationals involved with your research? Export Control Review Form Attached Have EAR/ITAR regs been reviewed? If "yes", : Does a conflict exist? Updates/Changes? Financial Conflict of Interest Filed Date: Certified for NIH Research Services Received Compliance Received GCFA Received Research Services Completed Dean and/or Director Date Department Head Date Principal Investigator Date Vice President for Research Date Director of GCFA Date Research Compliance Date Org. Code Address PI's Department/School Approvals: Signatures acknowledge that the actions requested on this form and any attachments are consistent with department/division/university policy & objectives, and that all parties' commitments to the project are noted and approved. Principal Investigator/Co-PIs acknowledge all compliance requirements have been met. Yes No Prepared by: PH # Part 4 Part 5 International travel Out In None Is there confidential information: Both Rm# Amount $: Pending OR Resolved Yes No (Required for RS routings.) Banner ID Version 3.0 (7-19) Research Type: Applied Basic Developmental Reset /NA Involves CLASSIFIED information (If yes, Facility Security Officer should be contacted.) Does sponsor reference FISMA or FISMA-like language or CUI? Will this project need resources from the HPCC? Yes No Human Subjects Animal Use IACUC# Expires on Recombinant DNA No Yes No Yes No Yes No Yes IBC# Infectious Agents, Toxins, Prions Expires on Radioactive Materials/ X-ray Devices Laser Safety Inspection (Class 3b & 4) Space is available for this project: Appl# Yes No Approved Yes No Yes No Yes No Yes No Yes No Yes No If "yes", where: Yes No Date Signed: Yes Pending No Comments & Special Information: Provide any relevant details to help explain reason for routing action. Specify such things as budget changes, no cost extension, change in personnel. Provide split budget information, if applicable. NIH FCOI Training Date: End Date
