………………………………………………………………………………………………………… …………………………… ………………………………………………………………………………………………………… …………………………… Identification of local bodies for collaboration in research and development – explain how they will collaborate i)……………………………………………………………………………………………………………… ……………………… ………………………………………………………………………………………………………………… …………………… ………………………………………………………………………………………………………………… …………………… ii)……………………………………………………………………………………………………………… ……………………… ………………………………………………………………………………………………………………… …………………… ………………………………………………………………………………………………………………… …………………… iii)……………………………………………………………………………………………………………… ……………………… ………………………………………………………………………………………………………………… …………………… ………………………………………………………………………………………………………………… …………………… Confidential Information Put statement on how any confidential information shall be treated. Benefit sharing arrangements: Expected kinds / types of benefits Beneficiary* ……………………………………………………………………… …………………………………………………………… ……………………………………………………………………… ……………………………………………………………… ……………………………………………………………………… ……………………………………………………………… ……………………………………………………………………… ……………………………………………………………… ……………………………………………………………………… ……………………………………………………………… ……………………………………………………………………… ……………………………………………………………… * please attach separate sheet indicating the number of people expected to benefit, their names and location Depository: A depository for representative samples or specimens and or intangible components of the genetic resources to be collected has been designated as: ………………………………………………………………… ………………………………………………………………………………………………………………… ………………………… Access to the Genetic Resources: Guidelines for Access to Genetic Resources and Benefit Sharing  38 

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