Application for Registration (DEA Form 363), Application for Registration Renewal (DEA Form 363a), Application for Registration Renewal (Chain) (DEA Form 363b)
ICR 200208-1117-003
OMB: 1117-0015
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1117-0015 can be found here:
Application for Registration
(DEA Form 363), Application for Registration Renewal (DEA Form
363a), Application for Registration Renewal (Chain) (DEA Form
363b)
Extension without change of a currently approved collection
Practitioners who dispense narcotic
drugs to individuals for maintenance or detoxification treatment
must register with the DEA under the Narcotic Addict Treatment Act
of 1974. Registration is needed for contol measures and is used to
prevent diversion.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.