DHHS Agreement Date: 10/18/12

Animal Welfare Assurance Number: A-3209-01

AAALAC Accreditation Number: 000551

Human Subjects Assurance of Compliance Number: FWA00003491

Congressional District: 13

Senatorial District: 50

Representative District: 99

Entity Identification Number: 376005961

DUNS Number: 038415006

IDHR Number: 110743-00

IPF Number: 1194504

Applicant Organization:

Board of Trustees of Southern Illinois University
Carbondale, Illinois 62901

Signing Official / Fiscal Officer

Linda A. Toth, D.V.M., Ph.D.,
Associate Dean for Research
and Faculty Affairs

Official Signing for Applicant Organization

Please contact Pam Burk at 545-8174 or Bebie Custeau at 545-4549 to determine which signature block is appropriate for your application. Choose one of the following three:

Linda A. Toth, D.V.M., Ph.D.,
Associate Dean for Research for Rita Cheng, Chancellor
Southern Illinois University Carbondale
Pamela J. Speer
Associate Provost for Finance and Administration for Rita Cheng, Chancellor Southern Illinois University Carbondale
Connie Hess
Assistant Provost for Financial Affairs for Rita Cheng, Chancellor
Southern Illinois University Carbondale