APPENDIX A

INITIAL DECLARATIONS

[INFORMATION TO BE PROVIDED IN DECLARATIONS OF PAST BIOLOGICAL AND TOXIN OFFENSIVE AND/OR DEFENSIVE [PROGRAMMES] [ACTIVITIES]]

1. Name of State Party:

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2. Date of entry into force of the Convention for the State Party:

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3. Date of initial declaration:

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PART A

PAST BIOLOGICAL OFFENSIVE [PROGRAMMES] [ACTIVITIES]

[ Past offensive biological research and development programmes.

(a) Yes / No

(b) Period(s) of activities:

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(c) Summary of the research and development activities indicating whether work was performed concerning production, testing and evaluation, weaponization and/or stockpiling of biological agents, the destruction programme of such agents and weapons, and other related research:

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OR

[1. At any time since [17 June 1925] [1 January 1946] [26 March 1975] have you conducted any activities as specified in Article III, section D, subsection I, paragraph 6?

YES / NO

2. Indicate the [period(s)] [years of operation] of the [programme(s)] [activities] during the declarable period:

..............................................................................................................................................

[3. Did [a programme] [activities] exist before 17 June 1925?

YES / NO

If yes, indicate the date of establishment of the [programme(s)] [activities]:

..............................................................................................................................................]

4. Indicate whether any research and development activities or other work on microbial or other biological agents or toxins [or on pests and vectors] were carried out for hostile purposes or for use in armed conflict:

5. Give a summary of each subject indicated as "YES" in paragraph 4 above:

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6. Indicate whether any research and development activities or other work was carried out on equipment or means of delivery for microbial or other biological agents or toxins for hostile purposes or for use in armed conflict:

[7. Give a summary of each subject indicated as "YES" in paragraph 6 above:

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8. Have any microbial or other biological agents or toxins ever been used for hostile purposes or in armed conflict?

YES / NO

9. If "YES" in paragraph 8, give a summary of each case indicating the agent(s), date(s) and place(s):

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[10. List all facilities, including their addresses, activities and purposes, that participated in the [programme(s)] [activities] and indicate which had been destroyed when and how it was done. Describe what was done with all the facilities that were not destroyed:

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[11. Was any maximum containment facility constructed for use in the biological offensive [programme(s)] [activities]?

YES / NO

If yes, indicate the floor area of each facility:

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[12. List all test ranges, including their addresses, activities and purposes, used in the [programme(s)] [activities] and give a description including dates of the dismantling or conversion of each:

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[13. Indicate what all the converted facilities and test ranges are presently being used for:

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14. List all microbial or other biological agents and/or toxins [studied,] [worked on,] [worked with,] [developed,] produced, otherwise acquired, stockpiled or weaponized:

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[15. If agents and/or toxins were produced, indicate the cumulative amount of each agent and toxin produced since 17 June 1925:

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[16. If agents and/or toxins were stockpiled, indicate the cumulative amount of each agent and toxin stockpiled since 17 June 1925:

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[17. Indicate which produced or otherwise acquired, stockpiled or weaponized agents and/or toxins listed in paragraph 14 above were destroyed, how, where and when it was done. Give a summary of what was done with those not destroyed:

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[18. Give a summary of the destruction or conversion of the equipment or means of delivery described in paragraph 7 above:

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[19. State the present status of the data, video recordings, etc. obtained when the [programme(s)] [activities] was in operation:

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PART B

PAST BIOLOGICAL DEFENSIVE [PROGRAMMES] [ACTIVITIES]

[ Past defensive biological research and development programmes.

(a) [Yes / No] [Existed / did not exist].

(b) Period(s) of activities.

(c) Summary of the research and development activities indicating whether or not work was conducted in the following areas: prophylaxis, studies on pathogenicity and virulence, diagnostic techniques, aerobiology, detection, treatment, [toxinology,] [toxicology,] physical protection, decontamination, and other related research, with location, if possible.]

OR

[1. Did [a] past defensive [programme] [activities] exist?

YES / NO

2. Indicate the period(s) of the [programme] [activities] during the declarable period:

..............................................................................................................................................

3. Give a summary of the general objectives of the [programme] [activities], whether any research and development [, testing and evaluation or production] was done:

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4. Indicate whether any research and development [, testing, evaluation or production [, or other work]] was conducted in the following areas:

5. Give a summary of each subject indicated in paragraph 4 above:

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[6. Describe the principle objectives of any production or other acquisition activities for equipment or other items as part of the [programme] [activities]:

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7. List all microbial or other biological agents or toxins [studied,] [worked on,] [worked with,] [developed,] [produced, otherwise acquired or stockpiled] as part of the [programme] [activities]:

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..............................................................................................................................................

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[8. [List all facilities which participated in the programme and indicate which are still involved in a present programme, if any] [List all facilities with name, postal address, location which participated in the activities and indicate which were converted or dismantled or destroyed and when it was done. Describe what was done with all the facilities that were not dismantled or destroyed]:

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[PAST BIODEFENCE FACILITY⁷²

For each facility complete one form. Crucial starting date is 17 June 1925.

GENERAL INFORMATION

1. Name and postal address:

2. Location:

3. Scale map:

4. Owner(s):

5. Operator(s):

6. Years of operation since 17 June 1925:

7. Was the facility under operation before 17 June 1925? If so, indicate the date of establishment of the facility:

8. Description of the type of work that was undertaken:

	Relevant agent/ toxin	Name/ type	Develop- ment	Produc- tion	Evalua- tion	Quantity, if appli- cable	Year
Vaccine
Plant inoculant
Pharmaceutical product
Diagnostic reagent
Other products (specify)

9. Was the facility used for any of the following?

10. Floor area of BL4 (maximum containment) facility constructed for biodefence purpose:

11. What is the present work carried out in the facility, if it is in use?

12. If not in use, when was the facility dismantled?]

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