Information Collection

Registrants Inventory of Drugs Surrendered--DEA Form 41

IC 12289 under ICR 201705-1117-001 · OMB 1117-0007.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1117-0007 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 41 Registrants Inventory of Drugs Surrendered--DEA Form 41	Form
41 Registrants Inventory of Drugs Surrendered 2012.05.07 - Modified DEA Form 41 (clean).pdf www.deadiversion.usdoj.gov/21cfr_reports/surrend/index.html	Form
41 DEA Form 41 41_form.pdf www.DEAdiversion.usdoj.gov	Form

IC Title:

Registrants Inventory of Drugs Surrendered--DEA Form 41

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	41	Registrants Inventory of Drugs Surrendered	2012.05.07 - Modified DEA Form 41 (clean).pdf	http://www.deadiversion.usdoj.gov/21cfr_reports/surrend/index.html	Yes	No	Printable Only
Form	41	DEA Form 41	41_form.pdf	www.DEAdiversion.usdoj.gov	Yes	No	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Substance Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 92,924

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	92,924	5,188	87,736
Annual IC Time Burden (Hours)	46,462	2,594	43,868
Annual IC Cost Burden (Dollars)	985,234	56,987	928,247

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.