Sample Request Form-FOR GC-MS ANALYSIS [External Users]

Soft copy# of this form is available online at www.vit.ac.in. (Please tick boxes () as applicable).

SOPHISTICATED INSTRUMENTATION FACILITY (SIF)

Chemistry Division
School of Advanced Sciences
VIT University, Vellore 632 014, Tamil Nadu
Sample Name/ID/code
Date of Requesting
Analytical Report No (SIF Use)
Received Time (SIF Use)
Description (Semi Solid/ Solid/
Liquid)
Analysis required # GC-MS-EI GC-FID Method Purity Quantification
(Please make sure that the compound is [ ] [ ] Validation check [ ]#
pure) [ ]# [ ]#
Solubility of the Compound
Molecular Weight of the Compound
(If unknown approx. range must be given
& should be below m/z: 600)
Melting (or) Boiling point of the
Compound MP: BP:
Polarity of the compound Polar [ ] Mid polar [ ] Non polar [ ]
Library Search required Yes [ ] No [ ]
Report format Email ID : Hardcopy by post (Address):

User Information:
Name :
Phone No :
Designation :
Institution / Organization :
Purpose : M.Phil. [ ] /Ph.D. Work [ ] / Industrial Analysis [ ] / Project Work [ ]
Other Information about the compound: [Pl. tick ]
Hygroscopic [ ] / Column Purified [ ]/ Recrystallized [ ]/ Polymerizable [ ]/ Stable at RT [ ]

* For more than one sample, provide the Information on separate sheet, Samples codes, Molecule Weight, Boiling Point and solubility of
the samples (Only Organic Solvents).

Demand Draft Details:

Amount Rs : Demand Draft Number & Date :
Name of the Bank : Branch of the Bank :

1
GC-MS Charges [In Rs.]* w. e. f. April, 2015
Amount in Rs. :_____(DD should be taken in favor of VIT University, payable at Vellore)
Sr. No. Academic Industrial Specification Remarks

1 340 910 Per Sample per hour without library facility All the Rates are
Inclusive of Service
Tax as per Rule of
2. 570 1600 Per Sample per hour with library facility
Government of India.

* Please Note:
1. Please send the DD along with the requisition form.
2. Reports will be released only when full payment is received as given in the above table.
3. Write the feedback to improve the services
4. For more than one sample, provide the Information on separate sheet, Samples codes,
Molecule Weight, Boiling Point and solubility of the samples (Only Organic Solvents).
5. Water samples and water soluble compound will NOT be accepted.
6. Method Validation: Please attach the guidelines, parameter limits and other details such as
Precision, Linearity, and Accuracy etc. Additional charges will be charges for method validation.
7. The spectral information is given only for investigation purpose with your requisition. It should
NOT be used as Certificates in lawful argument.
8. Radioactive/Explosive/Unstable samples are NOT accepted for analysis.
9. As per rule of GC-MS committee, it is obligatory for user of Sophisticated Instrumentation
Facility VIT University Vellore, to acknowledge the facility in their research work and
communicate the same to SIF, VIT University Vellore for communicating to DST, New Delhi. This
condition is compulsory for availing Economical Educational Institution Price (EEIP) for
Educational Institutes. Research scholars are recommended to send their samples through their
Supervisor or Head of Department to avail the EEIP facility. The EEIP is provided to only those
users who frequently give us response about the end-use of the result through the
acknowledgement in their publications.

All the correspondence should be address to:

Faculty I/C
Sophisticated Instrumentation Facility (SIF)
School of Advanced Sciences
V I T University, Vellore Campus
Tamil Nadu, India, 632 014
0416 220 2871, sifchemistry@vit.ac.in
Acknowledgement/ Feedback form/suggestions:
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[N.B.:-For Availing FT-IR and UV-Vis-NIR Facility, Pl Ref. NEXT Page]

2
 (Sophisticated Instrumentation Centre)
Chemistry Division, SAS, VIT University, Vellore 632 014, Tamil Nadu

REQUISITION FOR FT-IR ANALYSIS

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Name : Position :
Institution/ Organization:
Email ID and Contact Number:
Purpose : PG project / M Phil project / PhD work Number of samples :
Details of samples :
Are they air and moisture sensitive? : Yes/ No
Mode of analysis : KBr Disc/ Solution*/ Nujol Mull [*Please mention the solubility of the samples
here (The usual solvent is CH2Cl2 and the aqueous solutions will not be accepted for solution mode)].

Signature of the Student/Scientist Signature of the Guide /Manager

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REQUISITION FOR UV-VIS-NIR ANALYSIS
-------------------------------------------------------------------------------------------------------
Name : Position :
Institution/ Organization:
Email ID and Contact Number:
Purpose : PG project / M Phil project / PhD work Number of samples :
Details of samples : Solubility:
Mode of analysis : Diffuse Reflectance(0.100g)/Solution/Thin film
Spectral range required : (200-2500nm);

Signature of the Student/Scientist Signature of the Guide/Manager

***Amount in Rs. :

(Academic Samples Rs. 150/-each sample for FT-IR or UV/Vis Spectrum

Industrial Samples Rs. 400/-each sample for FT-IR or UV/Vis Spectrum; DD should be taken in favour of
VIT University, payable at Vellore)

Demand Draft Number with Date :