Today's Date
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Today M-D-Y
Cost Center (REQUIRED , even if third party account is being used):
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Third Party Account #
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Your Full Name
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Your UTD Email
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Your Phone Number (in case of an emergency)
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What would you like to ship? Select all that apply.
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Batteries or Power Packs
Biological Material
Chemical Samples
Dry Ice
Electronic Devices
International General Correspondance or Documents
International Tangible Items/Products
International Technical Data/Software
Radioactive Material
Would you like access/training to ship Dangerous Goods through eShipGlobal?
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Yes No
Proposed Shipping Date
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Today M-D-Y
Company/Contact Name
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Company/Contact Telephone #
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Street Address
City
State
Country
Postal/Zip Code
Street Address
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State
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Country
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Postal/Zip Code
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Package Type
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Box
Tube
Letter/Envelope
PAK
Weight (lbs)
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Dimensions (L x W x H in inches)
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Requires insurance in the amount of:
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Number of items in shipment (pieces, pages, etc.)
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Net Value in USD
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Purpose of shipment
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Domestic International
Speed of service for domestic shipping
Important Note: Processing may take additional time if approvals are required before a shipping label can be generated. Please plan accordingly.
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Priority (next day AM delivery)
Standard (next day PM delivery - 3:00 PM)
Express Saver (2-3 business days)
Ground
Select priority time for domestic shipping.
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8:30 AM (most expensive) 10:30 AM
Speed of service for international shippingImportant Note: Processing may take additional time if approvals are required before a shipping label can be generated. Please plan accordingly. Available carriers may vary by region.
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Priority (approximately 24-48 hours from approval date) (not available in all regions)
Economy (2-3 business days from approval date)
One of the major risks with transport of batteries and battery powered equipment is short-circuit of the battery as a result of the battery terminals coming into contact with other batteries, metal objects or conductive surfaces. Packed batteries or cells must be separated in a way to prevent short circuits and damage to terminals. All packages must have strong rigid outer packaging unless when contained in equipment. Fully enclosed inner packaging made of non-conductive materials such as a plastic bag is recommended. Remember to separate or otherwise prevent contact with other batteries by use of non-conductive tape or other appropriate means. All batteries should also be securely cushioned during shipment. Since eShipGlobal does not provide this service, the shipping team will work with the customer to complete this shipment.
What type of batteries are you shipping?
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Button (coin cell) batteries
Portable power banks
Lithium-ion
Other
Are you shipping lithium-ion batters that are:
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Contained in equipment
Packed with equipment
Neither
How many lithium-ion batteries are being shipped?
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Do you have a lithium battery test summary available from the manufacturer or distributor for the cells or batteries being shipped?
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Yes, I will attach a copy with this form.
No, I do not have one.
Please attach the battery test summary.
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Please contact DG-Ship@utdallas.edu or the Radiation Safety Office at 972-883-3530 for assistance with your radioactive material package.
Does this package of research material contain a culture or stock of a human pathogen associated with any of the following: Select Agents designated by the U.S. Department of Health & Human Services (HHS); Risk Group 4 Agents; Genetic derivatives of HHS Select Agents or Risk Group 4 Agents; or Agents listed on the Indicative Examples of Infectious Substances affecting humans included in Category A?
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Yes
No
Does this package of research material contain a culture or stock of an animal pathogen associated with any of the following: Select Agents designated by the U.S. Department of Agriculture (USDA); Genetic derivatives of USDA Select Agents; Agents listed on the Indicative Examples of Infectious Substances affecting animals included in Category A?
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Yes
No
Does this package of research material you are shipping meet any one of the following criteria:
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A human, animal or plant pathogen, or infectious agent in a virulent or attenuated form (including pathogenic bacteria, viruses, viral vectors, parasites, fungi, algae, or prions)?
Known to harbor a pathogen?
Have a high probability of containing a pathogen?
Human origin (e.g. established or primary cell lines, tissue, organs, blood, or body fluids)? (Samples where there is minimal likelihood that pathogens are present are excluded. If the medical history or other patient information is unknown, then please answer "yes".)
Of non-human primate origin (e.g. established or primary cell lines, tissue, organs, blood, or body fluids)
None of the above
Is the material a genetically modified microorganism that does not meet the definition of an infectious substance or toxic material (e.g. recombinant E. coli K12 containing the GFP gene or Staphylococcus aureus with a gene deletion)?
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Yes
No
If yes, please describe.
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Exempt Human or Animal Specimen Is the material a human specimen or material for which there is only a minimal likelihood that pathogens are present?
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Yes
No
Is the material an animal specimen or material for which there is only a minimal likelihood that pathogens are present (e.g. rodent, avian, porcine cells, tissue, organs, blood, or body fluids)?
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Yes
No
Are you shipping a non-regulated biological material on dry ice (purified proteins, DNA/RNA extracts)?
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Yes
No
Any material that was received from another party under an agreement (e.g., Material Transfer Agreement, sponsored research agreement, or commercial purchases with use limitations) that prohibits or limits redistribution or further transfer of such material?
Yes
No
What is the physical state of your sample?
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Solid
Liquid
Pressurized Gas
Please give a brief description of the biological material you would like to ship.
Source of Dangerous Goods Material Examples: Biological (ATCC, Patient Specimen), Chemical (lab synthesized or manufacture’s name)
Materials / Composition Examples: bacteria, virus, cell lines, tissues, proteins manganese oxides, ferro silico magnesium
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What is the physical state of your sample?
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Solid
Liquid
Solid in a buffer
Solid in a fixative
How many samples are you preparing?
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How much of the sample (grams or milliters) are you shipping?
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Primary receptacle - What are you placing your sample in?
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1.5-mL Eppendorf tube
15-mL centrifuge/falcon tube sealed with parafilm
Other
Please describe the type of primary receptacle you are using.
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Secondary receptacle - What are you placing your primary receptacle in? All secondary receptacles must be placed in a cardboard box - the tertiary receptacle.
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A small box for multiple samples
A zip-lock baggy with absorbent (e.g. paper towels)
A zip-lock baggy with absorbent (e.g. paper towels) nested in a styrofoam box with dry ice
A styrofoam box with dry ice
A styrofoam box with wet ice
A styrofoam box with gel packs
A zip-lock baggy with absorbent (e.g. paper towels) nested in a styrofoam box with gel packs
Is the material suspected to be infectious, BSL1 or BSL2?
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BSL-1
BSL-2
No, this material is not infectious.
Is there a chemical preservative added to the biological sample?
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Formalin
Ethanol
Isopropanol
Alcohols other than Ethanol and Isopropanol
No chemical preservative added
How much volume of the preservative are you using? Please note, volumes should not exceed 30 mLs.
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What is the volume per sample of the chemical preservative? Please be aware that the total volume of chemical preservative cannot exceed 30 mLs.
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5 mL
10 mL
15 mL
20 mL
25 mL
30 mL
What is the chemical name of your sample?
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Please add a CAS number, if applicable.
How many sample vials are you shipping?
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Please attach an SDS that is representative of the chemical reagent being shipped.
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Does this sample contain a chemical that was synthesized in the lab and does not have an assigned CAS number?
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Yes
No
Please describe the sample with enough detail to determine physical hazards during transportation.
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It is important to provide an exact quantity of dry ice used for shipments. How many pounds of dry ice will you need?
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Do the documents in your shipment contain information that might be used in the development of military or terrorist weapons?
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Yes
No
I don't know
Do the documents in your shipment include or disclose confidential, sensitive, or export-controlled information?
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Yes
No
I don't know
Do the documents in your shipment contain technical data, blueprints, formulae, design instructions, etc., for equipment or software?
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Yes
No
I don't know
Do the documents contain any confidential personal information, such as SSN, Student ID numbers, etc.? Please bring the package unsealed.
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Yes
No
Please indicate the number of pages in the document(s).
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Do/can the technical data in your shipment be used in the development of military or terrorist weapons?
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Yes
No
I don't know
Do/can the technical data in your shipment contain confidential, sensitive, or export-controlled information?
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Yes
No
I don't know
Do/can the technical data in your shipment have application in the development, use, or production of high-tech equipment or processes involving nuclear materials, chemicals, microorganisms and toxins, electronics, computers, telecommunications, information security sensors and lasers, navigation and avionics, marine, or aerospace and propulsion?
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Yes
No
I don't know
Do/can the technical data in your shipment involve an agreement imposing publication restrictions, non-disclosure, or confidentiality?
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Yes
No
I don't know
Please describe what Technical Data you are shipping.
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Does/can the product or article in your shipment be used in the development of military or terrorist weapons?
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Yes
No
I don't know
Does/can the product or article in your shipment contain confidential, sensitive, or export-controlled information?
* must provide value
Yes
No
I don't know
Does/can the product or article in your shipment have application in the development, use, or production of high-tech equipment or processes involving nuclear materials, chemicals, microorganisms and toxins, electronics, computers, telecommunications, information security sensors and lasers, navigation and avionics, marine, or aerospace and propulsion?
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Yes
No
I don't know
Does/can the product or article in your shipment involve an agreement imposing publication restrictions, non-disclosure, or confidentiality?
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Yes
No
I don't know
Does your shipment contain technology described in, or in part of, an invention disclosure that UTD is protecting or has protected by one or more patents or pending patents?
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Yes
No
I don't know
Does your shipment contain intellectual property (IP) exclusively licensed by UTD to another party?
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Yes
No
I don't know
PDF of Submitted SIF Request
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