AOAC PERFORMANCE TESTED METHODS (PTM) MOD

APPLICATION FOR METHOD REVISIONSfor Proprietary and Sole Source Methods

NOT FOR RENEWAL MODIFICATIONS
PART I - AUTHORIZED METHOD SUBMITTER

CONTACT INFORMATION

Please note that this application must be completed and submitted by the contact that is authorized by the organization to pursue and obtain validation and/or the development of protocols. All correspondence in relation to this application will be directed to the contact listed in this section.
First Name*
Last Name*
Title*
Organization*
AOACRI Account ID#
Address*
Include City/Town, State/Country & Postal Code*
Email Address*
Telephone*
Legal Name of Method and PTM number:*

PART I.A. - FINANCIAL CONTACT INFORMATION

Please provide the contact information for the person within your organization that will be responsible for recieving and processing the payments for invoicing.
Financial Contact: First Name*
Financial Contact: Last Name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone*
E-mail

PART II - TERMS & CONDITIONS

Please read all Terms and Conditions. (Certain items are subject to change).
AOAC Research Institute Fee Schedule

AOAC Terms and Conditions 2023v1
NOTE: All modifications are subject to detailed review to assess correct level of modification/extension. Identical modifications for Levels 1 & 2 must be submitted at the same time on the same application and will be reviewed to assure full requirements are met prior to granting discount.

All documents uploaded with the application will be handled as confidential according to the PTM Programs Policies and Procedures.
*I have read and agree to the terms and conditions.

AcceptDecline

PART III - METHOD REVIEW
Did you submit an application for Consulting?*

I have submitted for ConsultingYes - I had ConsultingNo - I don't need Consulting
Please select the appropriate method review program:*

AOAC Performance Tested (PTM) - ModificationAOAC Performance Tested (PTM) & AOAC Offical Methods (OMA)
Is your method being submitted to participate in a call for ERV or Targeted Matrix Extension (TME)?

YES - ERVYES - TMENO to both
* OMA modifications will require a seperate OMA modification application. Contact Deborah McKenzie ( DMckenzie@aoac.org) for further information.

PART VI - AUTHORIZATIONS FOR SUBMISSION
Is this method recognized or adopted by another organization or agency outside of AOAC?*

YESNO
Please list the name(s) of the organization(s) or agency(ies).*
Does the organization(s) or agency(ies) support the proposed modification being submitted to AOAC?*

YESNO
Please provide the name and contact information (including email ) for the primary or secondary representative at the organization(s) or agency(ies) as it relates to this method.*
Please describe why the organization(s) or agency(ies) listed in this section does (do) not support the proposed modification.*
Applications will be viable for one (1) year from submission. New submission will be required for projects not initiated within the one year term.

Invoices not paid or initiated within 180 days will be at risk of project closure.

Application for identical group modifications will be reviewed to assure requirements are met to qualify as a bundle submission.
* NOTE: For modifications pertaining to OMA methods, a modification application will be required with the AOAC Official Methods Program. Please contact Deborah McKenzie (DMckenzie@aoac.org) for further information.
Date Submitted*

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Date