Form 590-1 NIH Guest Researcher Agreement

Special Volunteer and Guest Researcher Assignment (OD)

SSA Attach 3 - Form NIH-590-1 OMB 0925-0177 NIH GR Agreement

NIH guest Research Agreement

OMB: 0925-0177

Document [pdf]
Download: pdf | pdf
NIH Manual 2300-308-1, Appendix 2
Date: 11/23/11
Replaces: 8/16/11
Issuing Office: OD/OIR (301) 496-1921

OMB 0925-0177
Expiration Date: February 28, 2021

NIH Guest Researcher Program

NIH Guest Researcher Agreement
I,
a Guest Researcher that I will:

(name) hereby agree in consideration of acceptance by NIH as

1. Agree to be bound by all provisions of Executive
Order 10096, as amended, 45 C.F.R. Part 7 and
any orders, rules, regulations or the like issued
thereunder, as if I were a Government employee
who conceived an invention or first actually
reduced it to practice while at the NIH. I agree to
disclose promptly to the appropriate NIH officials,
all inventions which I may conceive or first
actually reduce to practice during my visit to the
NIH, and to sign and execute all papers necessary
for conveying to the Government the rights to
which it is entitled by virtue of Executive Order
10096, as amended, and this agreement.
2. Submit publications resulting from work at NIH to
be cleared for conformance with NIH’s publication
policies.
3. Waive any and all claims for compensation from
the Government of the United States for any
services performed incidental to the personal
research I am doing, and absolve NIH of any
responsibility in case of personal injury or death
arising out of those research activities, and/or
failure or damage to my experiments or equipment.
4. While on NIH premises, conform to all applicable
administrative instructions and requirements of the
Department of Health and Human Services and
NIH, including all regulations and procedures
concerning conduct, safety, patient care, and animal
care.

Guest Researcher’s Signature

NIH 590-1 (02/18)

Date

5. Agree that I will obtain, prior to the beginning of
this assignment, health insurance coverage
substantially comparable to that provided by the
Federal Employee’s Health Benefits Plan and will
have that coverage approved by the host IC.
6. If not a US citizen or permanent resident, agree to
provide evidence of valid non-immigrant status and
employment eligibility to the Division of
International Services, ORS, for the duration of the
assignment.
Please check this box if you will receive a salary or
stipend while at NIH that is derived in any way
from, or related to, Federal (including NIH) funds
(e.g., grants, contracts, training awards). Specify
details on a separate page.
Public reporting burden for this collection of information is estimated
to average 5 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor,
and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden to: NIH, Project Clearance Office, 6701 Rockledge Drive,
MSC7730, Bethesda, MD 20892-7730, ATTN: PRA (0925-0177).
Do not return the completed form to this address.

Signature of Outside Employer Responsible Official

Date


File Typeapplication/pdf
File TitleFORM NIH-590-1
SubjectNIH Guest Reseacher Agreement
AuthorPSC Publishing Services
File Modified2018-02-13
File Created2018-02-13

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