Get Dea Form 106

Filling out the DEA Form 106 is essential for reporting any theft or loss of controlled substances. This guide will provide a clear, step-by-step approach to successfully complete the form online.

Follow the steps to fill out the DEA Form 106 online.

1. Press the ‘Get Form’ button to access the DEA Form 106 and open it in your preferred online editor.
2. Begin by entering the name and address of the registrant in the corresponding fields, including ZIP code.
3. Next, input the phone number of the registrant, ensuring to include the area code.
4. Enter the DEA registration number assigned to the registrant.
5. Indicate the date of the theft or loss by selecting the appropriate date from the calendar option.
6. Specify the principal business of the registrant by selecting one of the available options.
7. Indicate the county in which the registrant is located.
8. Answer whether the theft was reported to the police by selecting 'yes' or 'no'.
9. Indicate if anyone was injured during the theft by selecting either 'yes' or 'no'.
10. Select the type of theft or loss by checking the appropriate box and completing any required follow-up information.
11. Provide details about the theft or loss, including the name and telephone number of the police department.
12. Answer the questions regarding the specifics of the pharmaceuticals or merchandise taken, including estimation of value when applicable.
13. If applicable, fill out the lost in transit section with the required details about the common carrier and consignee information.
14. Complete the list of controlled substances lost or stolen by entering trade name, NDC number, dosage strength, dosage form, and total quantity.
15. Verify all entered information for accuracy and completeness.
16. Save your changes, then download, print, or share the completed DEA Form 106 as necessary.

Complete your DEA Form 106 online today to ensure compliance with federal regulations.