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Shipping Samples to SSRL

General Information

Your Name *

Institution *

Phone *

Sample Information

Number of Liquid Nitrogen Dewars

Total Number of Cassettes

Total Number of Uni-Pucks

Number of Blue Shipping Containers for Elevated Temperature

Temperature Inside Blue Shipping Containers *

5 degrees

20 degrees

Total Number of Elevated Temperature Plates *

International Shipments

Is this an International Shipment?

Yes

Are you Working with Tigers USA? *

Yes

Read about US Customs delays in the Shipping Samples Manual

Remote Information

Is this a Remote Experiment? *

Yes

Do you want to Generate Return Shipping Request Forms Now? *

Yes

Agreement Signature

Agreement Contents Dewar Assigned Beam Time *

I certify that dewar(s) contain only liquid nitrogen and less than 50 mg of protein or class I biohazard.

Agreement Contents Dewar BeamlineXpress *

I certify that dewar(s) contain only liquid nitrogen, less than 50 mg of protein and no biohazards. No proprietary research will be performed.

Agreement Contents Containers Assigned Beam Time *

I certify that blue shipping containers contain less than 50 mg of protein and no biohazards.

Agreement Contents Containers BeamlineXpress *

I certify blue shipping containers contain less than 50 mg of protein and no biohazards. No proprietary research will be performed.

Customs Delay *

I acknowledge that by not using Tigers USA, this shipment may be delayed at US Customs.

Export Control *

I certify that I have read, concur with and carried out the terms, conditions and requirements for export as outlined in the Instructions for International Shipments.

Power of Attorney *

I certify that I have sent a Power of Attorney Form to SSRL.

E-mail Signature *

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