SINGLE STUDY IRB AUTHORIZATION AGREEMENTSingle Study Irb Authorization Agreement • February 22nd, 2023
Institution or Organization Providing IRB Review (Institution A): Rutgers, The State University of New Jersey Name of Institution A (IRB of Record) # FWA00003913 IORG0000357 Federal Wide Assurance (FWA) IRB Registration Number Institution or Organization Relying on the Designated IRB (Institution B): Name of Relying Institution B Federal Wide Assurance (FWA#) Address: [Street Address] [City, State, Zip] Parties and Studies The Officials signing below agree that Institution B may rely on the designated IRB of Rutgers University for review and continuing oversight of Institution B’s human subjects research described below. This agreement is limited to the following specific research project (one study only): Study Title(s) Rutgers Protocol Number(s) Rutgers Principal Investigator Non-Rutgers Study-Site Investigator (If Applicable) Last, First MI, Highest Earned Degree Last, First MI, Highest Earned Degree
