ANNEX IISupplementary provisions
ANNEX II Template for a due diligence declaration to be submitted at the stage of research funding pursuant to Article 5(2) PART A Information to be transmitted to the ABS Clearing House pursuant to Article 7(3) of Regulation (EU) No 511/2014 If the information provided is confidential within the meaning of Article 7(5) of Regulation (EU) No 511/2014, please provide it nonetheless, tick the respective box and provide the justification for confidentiality at the end of this Annex. If you marked as confidential essential information (such as about the genetic resources or traditional knowledge associated with genetic resources, access place, form of utilisation), without which the record would not be published on the website of the ABS Clearing House, this information will not be shared with the ABS Clearing House, but it may be passed on directly to the competent authorities of the provider country. At least one declaration is required per grant received, i.e. different recipients under one grant may choose to submit either individual declarations or a joint declaration, through the project coordinator. I am making this declaration for the utilisation of: Please tick the appropriate box or boxes: ☐ Genetic resources ☐ Traditional knowledge associated with genetic resources 1. Subject matter of the research or identification code of the grant: ☐ Confidential 2. Recipient or recipients of funding, including contact details: Name: Address: E-mail: Telephone: Website, where available: 3. Information on exercise of due diligence: (a) ☐ An internationally recognised certificate of compliance (i) was issued for my (entity's) access or (ii) covers the terms of this access to the genetic resource(s) and traditional knowledge associated with genetic resources. Where this box is ticked, please indicate the unique identifier of the internationally recognised certificate of compliance: Please go to point 1 of Part B. (b) Where the box in point (a) has not been ticked, please fill in the following information: (i) Place of access: ☐ Confidential (ii) Description of the genetic resources or traditional knowledge associated with genetic resources utilised; or unique identifier(s), where available: ☐ Confidential (iii) Identifier of access permit or its equivalent ( 1 ) , where available: ☐ Confidential Please go to point 2 of Part B. PART B Information not to be transmitted to the ABS Clearing House 1. I declare that I will keep and transfer to subsequent user(s) a copy of the internationally recognised certificate of compliance as well as information on the content of the mutually agreed terms relevant for subsequent users. Please go to point 3. 2. I declare that I am in possession of the following information, which I will keep and transfer to subsequent user(s): (a) date of access; (b) person or entity having granted prior informed consent, where applicable; (c) person or entity to whom prior informed consent was granted (where applicable), if not granted directly to me or my entity; (d) mutually agreed terms, where applicable; (e) the source from which I or my entity obtained the genetic resource and traditional knowledge associated with genetic resources; (f) presence or absence of rights and obligations relating to access and benefit-sharing, including rights and obligations regarding subsequent applications and commercialisation. 3. Where the genetic resource(s) was(were) obtained from a registered collection, please provide the registration code of the collection: 4. The research grant is funded by the following sources: Private ☐ Public ☐ 5. Member State(s) in which the research involving utilisation of genetic resources and traditional knowledge associated with genetic resources takes place or has taken place: Confidentiality If you have declared that some information is confidential within the meaning of Article 7(5) of Regulation (EU) No 511/2014, please state the reasons for each piece of information for which you have declared that confidentiality applies: Date: Place: Signature ( 2 ) : ( 1 ) Evidence of the decision to grant prior informed consent or approval for access to genetic resources and traditional knowledge associated with genetic resources. ( 2 ) Signature of the recipient of funding or individual responsible within the research institution.