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Regione Abruzzo Comitato Etico Per La Ricerca REGIONE ABRUZZO COMITATO ETICO PER LA RICERCA BIOMEDICA DELLE PROVINCE DI CHIETI E PESCARA Sedi Operative : Via Dei Vestini gmB – 88àll Chieti Via Spaventa ’W – 88l’5 Lanciano Tel/ NPH:B SLLLON9N – Fax NPH:BSLLON9: http://richieste.comitatoetico.unich.it http://www.unich.it/ricerca/comitato-etico Indirizzo e.mail: [email protected] Oneri di funzionamento del Comitato Etico Tutte le tipologie di studi clinici noBprofit Gratuito Sperimentazione clinica B € O/9NNzNN VDA Centro coordinatore Vparere unicoA Sperimentazione clinica B Centro satellite € S/PLNzNN VDA Studio clinico osservazionale B di coorte prospettico € S/PLNzNN VDA Centro coordinatore Vparere unicoA Studio clinico osservazionale di coorte prospettico – € W/NNNzNN VDA Centro satellite Studio clinico osservazionale di altro tipo – Centro € W/PLNzNN VDA coordinatore Vparere unicoA Studio clinico osservazionale di altro tipo – Centro € :/NNNzNN VDA satellite Sperimentazione clinica di dispositivo medico – € O/9NNzNN VDA Centro Coordinatore Vparere unicoA Sperimentazione clinica di dispositivo medico – € S/PLNzNN VDA Centro satellite Emendamento sostanziale ad uno studio – € :/SNNzNN VDA Centro coordinatore Vparere unicoA Emendamento sostanziale ad uno studio – € :/:NNzNN VDA Centro satellite Emendamento non sostanziale Vpresa d’A € HLNzNN VDA Uso terapeutico di medicinale sottoposto a Gratuito sperimentazione clinica Vuso compassionevoA VDA E’ necessario aumentare l’importo da versare in misura fissa dell’imposta di bollo pari ad euro WzNNz trattandosi di documenti emessi fuori campo IVA e per importo superiore a HHzOH euro VDecreto Ministero Economia e Finanze del WO/NL/WNNLA/ Modalità di pagamento a carico del Promotore per l’attività del Comitato Etico Bonifico Bancario sul C / -5g5 BANCA POPOLARE DELL’EMILIA ROMAGNA – CHIETI ABI NLSPH CAB :LLNN CIg W INTESTATO g ASL lg LANCIANOuVASTOuCHIETI Via Martiri Lancianesi :HC:X – 99:NN CHIETI Partita Ivag NWSNH:SN9X9 Coordinate Bancarie IT8ll-’8Wà--llllllll-59g95 BIC VIFT CODEAg BPMOIWWXX REGIONE ABRUZZO COMITATO ETICO PER LA RICERCA BIOMEDICA DELLE PROVINCE DI CHIETI E PESCARA Sedi Operative : Via Dei Vestini 29/B – 66100 Chieti Via Spaventa 37 – 66034 Lanciano Tel. 0871- 35554060 – Fax 0871-3554061 http://richieste.comitatoetico.unich.it http://www.unich.it/ricerca/comitato-etico Indirizzo e.mail: [email protected] Causale : oneri Comitato Etico, codice, versione e data del Protocollo/Emendamento presentato dal Promotore, nome del responsabile locale della sperimentazione nonché il codice username a suo tempo rilasciato A NORMA DI QUANTO PREVISTO DALL’AGENZIA DELLE ENTRATE CON RISOLUZIONE N. 117 DEL 31 MARZO 2008, L’IVA NON E’ DOVUTA Il rilascio della quietanza/fattura avverrà esclusivamente dietro formale richiesta da parte del Promotore, attraverso il modulo di seguito riportato che dovrà essere compilato a cura dello stesso Promotore all’atto del versamento degli oneri e trasmesso all’Ufficio ragioneria della ASL Lanciano-Vasto-Chieti (0872-706780) ai seguenti indirizzi di posta elettronica: [email protected] [email protected] Eventuali ulteriori informazioni possono essere richieste alla segreteria tecnico- amministrativa del Comitato Etico Tel. 0871-3554060 Fax 0871-3554061 - 388 8093161 indirizzo e.mail [email protected] REGIONE ABRUZZO COMITATO ETICO PER LA RICERCA BIOMEDICA DELLE PROVINCE DI CHIETI E PESCARA Sedi Operative : Via Dei Vestini 29/B – 66100 Chieti Via Spaventa 37 – 66034 Lanciano Tel. 0871- 35554060 – Fax 0871-3554061 http://richieste.comitatoetico.unich.it http://www.unich.it/ricerca/comitato-etico Indirizzo e.mail: [email protected] MODELLO RICHIESTA FATTURA/RICEVUTA COMITATO ETICO ONERI DI FUNZIONAMENTO UOC Bilancio e Contabilità Via Martiri Lancianesi 17/19 66100 CHIETI Mail: [email protected] Titolo/Codice Sperimentazione:…………………..…………………………………. Emendamento Sostanziale …………………………………………………………… Emendamento non Sostanziale ………………………………………………………. Responsabile Locale Sperimentazione (PI) Dott/Prof. ……………………………………………………… RICHIESTA EMISSIONE FATTURA SI NO RICHIESTA RICEVUTA SI NO Il pagamento in parola è stato effettuato dalla seguente società: 1. RAGIONE SOCIALE…………………………………………………………………… 2. PARTIVA IVA/C.F……………………………………………………………………… 3. INDIRIZZO:………………………………………………………………………… 4. LOCALITA’………………………………………………………………………… 5. PAGATO EURO……………………………DATA…………………………………….. La suddetta fattura/ricevuta deve essere inviata al seguente indirizzo o email: ……………………………………………………………………………………………… Data ______ Firma .
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