NIST Administrative Manual, Subchapter 14.01
Transmittal Date - 1/24/00
APPENDIX A
SAMPLE EXEMPTION MEMORANDUM
MEMORANDUM FOR Name of Chairperson
NIST Institutional Review Board
From: OU Director
Laboratory
Subject: Exemption of Proposal for Research Involving Human Subjects
I have determined, in consultation with technical and legal experts, that the use of human subjects described in the attached proposal on "[insert name of project]"([insert name and phone extension of NIST P.I.]) meets the criteria for exemption from the policy of Part 27 of Title 15 of the Code of Federal Regulations.
This project involves two groups of human subjects. The first involvement of human subjects in this project fits into the category described in 15 CFR 27.101(b)(2) which is exempt from this policy:
The human subjects whose faces are projected on the computer screen make up the second group of human subjects involved in this project. The involvement of these subjects fits into the category described in 15 CFR 27.101(b)(4) which is exempt from the policy of Part 27:
Concur
_________________________________________
Michael Rubin, Counsel for NIST
Do Not Concur
_________________________________________
Michael Rubin, Counsel for NIST
Attachment
cc: J. Gagner
[insert name of DoC Financial Assistance Law Division staff member
assigned to NIST, if appropriate]
[insert name of Grants Officer, Contracts Officer, Chief of the Finance
Division, as appropriate]
[insert name of NIST P.I.]