10-1313-1
Merit Review Application
VA Form 10-1313-1 is the Merit Review Application, a Veterans Health Administration (VHA) research form. Its footer marks it as page 1 of the VA Form 10-1313 package. It identifies a research program and its principal investigators, the amount requested each year, the investigators' VA employment status and salary source, and how the program uses human or animal subjects, investigational drugs or devices, radioisotopes and biohazards. It is a VA research application, not a Veterans benefit application.
The form is one page with numbered items for the lab, application, review group, facility and investigator details, a summary of research support for three prior fiscal years, and signature lines for the principal investigator(s) and the ACOS for Research and Development.
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Lab number, application number, review group, review date, facility number, the location of the health care facility (VAMC, OPC, city, state), Social Security number and the date of last Merit Review submission.
The principal investigator(s), the program title (72 characters maximum) and the amount requested for each of the 1st to 5th years, with a total.
VA employment status, and the VA salary source: Research CC 103, 104, 105 or 110, Career Development CC 108, patient care, HSR&D, RR&D or other VA.
Program and cost center, primary research program area and specialty area, VA hospital service and section, and academic rank, department and affiliation.
Yes or no answers for human subjects, animal subjects, investigational drugs, investigational devices, radioisotope and biohazards.
Total VA, total non-VA and grand total research support for three prior fiscal years, the date entered on duty at VA, and the two signature and date lines.
Fill in the lab, application, review and facility details, the Social Security number and the date of the last Merit Review submission in Items 1 to 8.
List each principal investigator in Item 9 and enter the program title in Item 10, which the form limits to 72 characters.
Enter the amount requested for each year from the 1st to the 5th and the total in Item 11.
Check the employment status and salary source, then fill in the program, research areas, hospital service and academic details in Items 12 to 18.
The form says each item in Item 19 must have a response, so each of the six questions gets a yes or a no.
Fill in research support for three prior fiscal years and the VA entry on duty date, then the principal investigator(s) and the ACOS for Research and Development sign and date.
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The footer reads Page 1 of VA Form 10-1313 package. Other pages of the package on this site include VA Forms 10-1313-2, 10-1313-4, 10-1313-5 and 10-1313-6.
The form and VA's page do not print a mailing address or a submission method.
The PDF footer reads VA FORM 10-1313-1 DEC 2006, matching the December 2006 revision date on VA's page.
10-1313-2
6 fields, 1 page
10-1313-4
34 fields, 1 page
10-1313-5
8 fields, 1 page
10-1313-6
2 fields, 1 page
10-1313-13
46 fields, 1 page
The form's own fields and signature lines show who completes and signs it.
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It is the Merit Review Application, a VHA research form. Its footer marks it as page 1 of the VA Form 10-1313 package.
The form has signature and date lines for the principal investigator(s) and for the ACOS for Research and Development.
Item 11 has boxes for the amount requested in each of the 1st to 5th years, plus a total. Item 20 asks for research support in three prior fiscal years.
Item 10 says 72 characters maximum.
Yes. Item 19 says each item must have a response, covering human subjects, animal subjects, investigational drugs, investigational devices, radioisotope and biohazards.
The form and VA's page do not print a mailing address or a submission method.