Get Dea Form 106

Filling out the DEA Form 106 is a crucial step for registrants reporting the theft or loss of controlled substances. This guide will provide clear and supportive instructions on how to complete this form online, ensuring that you can navigate the process confidently.

Follow the steps to fill out the DEA Form 106 online

1. Press the ‘Get Form’ button to access the form and open it in your selected editor.
2. Provide your name and address, including ZIP code, in the designated fields. Ensure accuracy as this information is essential for identification.
3. Enter your phone number, including the area code, to facilitate communication if necessary.
4. Input your DEA registration number in the corresponding field for proper record-keeping.
5. Indicate the date of the theft or loss in the specified section, ensuring it is exact.
6. Fill in the county where you are located to provide location context.
7. Select whether the theft was reported to the police by choosing ‘Yes’ or ‘No’. If you choose 'Yes', provide the name and telephone number of the police department.
8. Specify if the theft has occurred within the past 24 months by entering the number of thefts or losses experienced.
9. Choose the type of theft or loss from the provided options, ensuring to complete any relevant items as instructed.
10. If applicable, provide the purchase value of the controlled substances taken.
11. Indicate whether any pharmaceuticals or merchandise were taken and estimate their value.
12. Complete additional details if the loss occurred in transit, including the name of the common carrier, consignee details, and any previous losses from the same carrier.
13. Describe any identifying marks on the containers that may help in identifying the lost products.
14. Specify any security measures you have implemented to prevent future thefts or losses.
15. Review the completed form for accuracy and ensure all required sections are filled out.
16. Once completed, save your changes, and choose to download, print, or share the form as needed.

Complete your documentation online today to ensure a swift and accurate reporting process.