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

Report of Theft or Loss of Controlled Substances

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.