Controlled Substances Import/Export Declaration--DEA Form 236

INSTRUCTIONS FOR COMPLETING DEA FORM-236

This form is to be used in notifying DEA of all Imports or Exports as required by Title III, PL91-513, Sections 1002 and 1003, as amended (Controlled
Substances Import and Export Act, 21 U.S.C. 952 and 953). This form may be prepared and signed by the actual Importer or Exporter or by the Broker or
Forwarding Agent used. The following instructions supplement the parts of the DEA-236 which are not completely self-explanatory.
Section 1. “IMPORTER” is the authorized DEA registrant who receives the controlled substance; “EXPORTER” is the authorized DEA registrant who ships the
controlled substance.
Section 2. Examples of typical entries in 2a:

Trade or Controlled Substance Name
50 Bottles
100 Tablets/Bottle
MG/15 Tablet
CSA Drug Code: XXXX
NDC Number: XXXX-XXXX-XX

2b:

Trade or Controlled Substance Name
600 Packages
2 Vials/Package
5 ML/Vial
2 MG/ML
CSA Drug Code: XXXX
NDC Number: XXXX-XXXX-XX

Controlled Substance Name
50 bottles X 100 tablets/bottle X
15 mg/tablet = 75,000 mg/1,000 = 75 gm

Controlled Substance Name
600 packages X 2 vials/package X
5 ml/vial X 2 mg/ml = 12,000 mg/1,000 = 12 gm

The DEA registrant should check the DEA Diversion webpage “www.deadiversion.usdoj.gov/quotas/conv_factor/index.html” to find the conversion factor of
the controlled substance if it contains a salt (ex. HCL, sulfate, tartrate).
2c. Return Information: For imports, the DEA registrant must provide the date and weight (base) of the controlled substance that arrived at their registered
location. For exports, the DEA registrant must provide the date and weight (base) of the controlled substance that departed from their registered location. If
available, the DEA registrant must provide the date and weight (base) of the controlled substance released by U.S. Customs and Border Protection (CBP).
Section 3. If this form is prepared as a Controlled Substance Import Declaration, list the foreign port of export (port name, city, country) from where the
shipment departs the country of export and the anticipated date it will depart in section 3a. In section 3b., list the U.S. port of import (port name, city, state) and
the anticipated date it will arrive.
If this form is prepared as a Controlled Substance Export Declaration, list the U.S. port of export (port name, city, state) from where the shipment
departs the United States and the anticipated date it will depart in section 3a. In section 3b., list the foreign port of import (port name, city, country) and the
anticipated date it will arrive.
Section 4. Insert name of vessel or airline and flight number, together with all intermediate carriers. Furnish all information concerning the transportation of
the goods known at the time of preparing the DEA Form-236.
Section 5. If this form is prepared as a Controlled Substance Import Declaration, enter the name and address of the foreign consignor. If this form is
prepared as a Controlled Substance Export Declaration, enter the name and address of the foreign consignee, the foreign import permit number and its date of
issue and expiration. Provide a document reference number for both types of delcarations.
INSTRUCTIONS FOR DISTRIBUTING DEA FORM-236
If this form is prepared as a Controlled Substance Import Declaration, distribute as follows:
The importer must provide an offical record of the declaration to the consignor who must submit the official record to the Competent National Authority of the
exporting country, if required as a prerequisite for an export authorization. The importer must ensure the official record of the declaration accompanies the
shipment to the registered location of the importer. The importer, or their agent, must submit the required data concerning the official record of the declaration to
the U.S. Customs and Border Protection (CBP) as part of the CBP import filing through the Automated Commercial Environment (ACE), or any successor system.
The importer must maintain an official record of the declaration in accordance with 21 CFR § 1304.
If this form is prepared as a Controlled Substance Export Declaration, distribute as follows:
The exporter must ensure the official record of the declaration accompanies the shipment to its destination. The exporter, or their agent, must submit the required
data concerning the official record of the declaration to the U.S. Customs and Border Protection (CBP) as part of the CBP export filing through the Automated
Commercial Environment (ACE), or any successor system. The exporter must maintain an official record of the declaration in accordance with 21 CFR § 1304.
PRIVACY ACT INFORMATION

AUTHORITY: Sections 1002 and 1003 of the Controlled Substances Act of 1970 (PL91-513), as amended (21 U.S.C. 952 and 953).
PURPOSE: To obtain information regarding the importation of nonnarcotic substances in Schedules III, IV, and V and the exportation of nonnarcotic substances
in Schedules III and IV and all substances in Schedule V.
ROUTINE USES: The Controlled Substances Import/Export Declaration produces special reports as required for statistical and law enforcement purposes.
Disclosure of information from this system is made to the following categories of users for the purposes stated.
A. Other Federal law enforcement and regulatory agencies for law enforcement purposes.
B. State and local law enforcement and regulatory agencies for law enforcement and regulatory purposes.
EFFECT: Failure to complete this form will preclude requested importation or exportation of the referenced controlled substances.

Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.
Public reporting burden for this collection of information is estimated to average 18 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Drug Enforcement Administration, FOI
and Records Management Section, 8701 Morrissette Drive, Springfield, VA 22152; and to the Office of Management and Budget, Paperwork Reduction Project
No. 1117-0009, Washington, D.C. 20503.