Request for Mass Spectrometric Services:  Sample Submission Form

Return to Shirley Clark c/o Dr. Robert  O. Fox, Director of The X-ray Crystallography Center, Sealy Center for Structural Biology, 5.162 MRB, rt 1055,  x76804, Fax # 772-5102

Sample I.D:___________________________________________  Date: ______________

Sample submitted by: ___________________________________  Phone  x___________

Name of PI:_________________________________________

Sample class; please check the following:              Net charge     + ion _____   - ion ______

protein______  nucleic acid______  other polymer_______ small organic molecule ______

If protein, was it reduced just before final purification?________ reductant: ____________

What is the estimated molecular weight range of the sample? ________________________    

What is the sample concentration?  (It should be at least 0.1uM)______________________

How was this concentration determined?________________________________________

What is the sample volume? (It should be 50 to 100ul)_____________________________

Does the sample have biologic activity?_________________________________________

Is the sample toxic? ________ Is it isotopically enriched?_________How?_____________

Can the sample be stored at 4oC for two weeks?__________________________________

Is the sample acid or base labile?______________________________________________

Samples must be purified by reverse-phase HPLC prior to mass spec. analysis (attach chromatogram indicating peak being submitted).  Check if RP-HPLC purified __________  

or 

Samples may be 0.2 micron filtered if free of salts and other contaminating non-volatile molecules.  Some buffers, salts, detergents, and non-volatile denaturants will damage the mass spectrometer. What is the solvent?__________________________

Please store sample in clear eppendorf tubes. Other tubes can leech polymers.


Signed _____________________________________________  Date________________

For internal use:

Date of sample run __________ Initials _______ File name ________________________

Comments: ______________________________________________________________