period, reports, etc.). Grants and contracts should be awarded to THE RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA and checks should be made payable to THE UNIVERSITY OF VIRGINIA. The Office of Sponsored Programs is the only office of this University officially delegated with the authority to negotiate binding grants and contracts between the University and its sponsors. The faculty are encouraged to make preliminary contacts with the sponsor relative to the scientific and technical aspects of proposals. Hosvever, negotiation of the final budget and the commitmentof University resources, financial or otherwise, must be performed by contacting the Office of Sponsored Programs, telephone (434) 924-4270. Your assistance in cooperating with the requests in this memorandum will be very much appreciated and should greatly expedite the processing and facilitate the administration of proposals and awards bv vour offices and our own. " Michael G. Glasgow, Jr. Assistant Vice President for Research Administration 1001 North Emmet Street, PO Box 400195, Cliarfattesville, VA22904 Phone: 434924-4270 Fax: 434-982-M96 315 Form Approved Through 09/30/2007 OMB No. 0925-0001 LEAVE BLANKFOR PHS USE ONLY. Department of Health and Human Services Public Health Services Type [Activity Number Grant Application Review Group Formerly Do not exceedcharacter length restrictions indicated. Council/Board (Month, Year) Date Received 1 . TITLE OFPROJECT (Donot exceed 81characters, includingspaces andpunctuation.) Prostate Cancer Bone Metastasis: Biology and Targeting 2. RESPONSE TO SPECIFIC REQUEST FOR APPLICATIONS ORPROGRAM ANNOUNCEMENT ORSOLICITATION ¿3 NOQ YES (If "Yes,"state number and title) Number: Title: 3. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR 3a. NAME (Last, first, middle) Lee, Jae K. 3c. POSITION TITLE Associate Professor 3e. DEPARTMENT, SERVICE, LABORATORY,OR EQUIVALENT Public Health Sciences 3f. MAJOR SUBDIVISION School of Medicine 3g. TELEPHONE AND FAX (Area code, number and extension) TEL: (434)982-1033 FAX: (434)243-5787 4 HUMAN SUBJECTS 4b.Human Subjects AssuranceNo. ¿c*¿prM FWA00006183 F?l n v 4C cllnicalTrial 4d. NIH-defined Phase III I2SI No U Yes g] NQ [-j yes c,inica|Trial [J No Q Yes New Investigator [>¿) No I I Yes 3b. DEGREE(S) 3h. eRA Commons User Name Ph.D. JAEKLEE 3d. MAILINGADDRESS (Street, city, state, zip code) University of Virginia Department of Public Health Sciences PO Box 800717 Charlottesville, VA 22908 E-MAIL ADDRESS: jaeklee@virginia.edu 5. VERTEBRATE ANIMALS ¿3 No Q Yes 5a. If "Yes," IACUC approval 5b. Animal welfare assurance no. Date 4a. ResearchExempt ._.._. K If"Yes," Exemption No. A3245-01 LJ No LJ Yes 6. DATES OF PROPOSED PERIOD OF 7. COSTS REQUESTED FOR INITIAL 8. COSTS REQUESTED FORPROPOSED SUPPORT (month, day, yearMM/DD/YY) BUDGET PERIOD PERIOD OF SUPPORT From Through 7a. Direct Costs ($) 7b. Total Costs (S) 8a. Direct Costs ($) 8b. Total Costs ($) 12/1/08 11/30/13 $20,061 $30,392 $106,507 $161,357 9. APPLICANT ORGANIZATION 10. TYPE OF ORGANIZATION Name UNIVERSITY OF VIRGINIA Public: -¿ D Federal El State CD Local Address PO BOX 400 195 Private: -> I I Private Nonprofit CHARLOTTESVILLE, VA 22904-4195 Institutional Profile File Number 1526402 12. ADMINISTRATIVE OFFICIAL TO BE NOTIFIED IF AWARD IS MADE Name GERALD J. KANE Title Director of Grants and Contracts Address OFFICE OF SPONSORED PROGRAMS PO BOX 400195 CHARLOTTESVILLE, VA 22904-4195 Tel: 434-924-4270 FAX:434-982-3096 E-Mail: gjk5y@virginia.edu 14. APPLICANTORGANIZATION CERTIFICATION ANDACCEPTANCE: I certify that the statements herein are true, complete and accurate to the best of myknowledge, and accept the obligation to comply with Public Health Services terms and conditions if a grant is awarded as a result of this application. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. PHS 398 (Rev. 04/06) Face Page For-profit: -> f~l General t~~l Small Business I I Woman-owned I I Socially and Economically Disadvantaged 11. ENTITY IDENTIFICATION NUMBER 1 546001 796A1 DUNS NO. 065391526 Cong. District 5th 13. OFFICIAL SIGNING FOR APPLICANT ORGANIZATION Name ERIK L. HEWLETT,M.D. Title Senior Associate Dean for Research Address OFFICE OF SPONSORED PROGRAMS PO BOX 4001 95 CHARLOTTESVILLE, VA 22904-4195 Tel: 434-924-8426 FAX:434-924-8725 E-Mail: sjw2b@virginia.edu SIGNATURE OF OFFICIAL NAMED IN 1 3. DATE (In ink. "Per" signature not acceptable.) ¿^4l/k^ ***"? Form Page 1 316 Principal Investigator/Program Director (Last, First, Middle): Chung, Leland W. K. DETAILED BUDGET FOR INITIAL BUDGET PERIOD DIRECT COSTSONLY PERSONNEL (Applicant organization only) Months Devoted to