Information Collection

Report of Theft or Loss of Controlled Substances -- DEA form 106

IC 12276 under ICR 201311-1117-001 · OMB 1117-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1117-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DEA-106 Report of Theft or Loss of Controlled Substances -- DEA form 106	Form
DEA-106 Report of Theft or Loss of Controlled Substances DEA-106 8-24-2011.pdf www.deadiversion.usdoj.gov	Form
106 DEA Form 106 106_form.pdf www.DEAdiversion.usdoj.gov	Form

IC Title:

Report of Theft or Loss of Controlled Substances -- DEA form 106

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DEA-106	Report of Theft or Loss of Controlled Substances	DEA-106 8-24-2011.pdf	www.deadiversion.usdoj.gov	Yes	No	Printable Only
Form	106	DEA Form 106	106_form.pdf	www.DEAdiversion.usdoj.gov	Yes	Yes	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Substance Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,655

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,430	9,655	613	15,162
Annual IC Time Burden (Hours)	8,477	3,218	205	5,054
Annual IC Cost Burden (Dollars)	475,060	180,102	293,977	981

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.