Information Collection

Report of Theft or Loss of Controlled Substances and Listed Chemicals - DEA Form 106 and DEA Form 107

IC 12276 under ICR 202311-1117-006 · OMB 1117-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DEA Form 106 Report of Theft or Loss of Controlled Substances and Listed Chemicals - DEA Form 106 and DEA Form 107	Form and Instruction
Form DEA Form 106 Report of Theft and Loss of Controlled Substances Report of Theft or Loss of Controlled Substances and Listed Chemicals - DEA Form 106 and DEA Form 107	Form and Instruction
Form DEA Form 107 Report of Theft or Loss of Listed Chemical Report of Theft or Loss of Controlled Substances and Listed Chemicals - DEA Form 106 and DEA Form 107	Form
DEA Form 107 instructions.docx apps.deadiversion.usdoj.gov/TLR/	Instruction
DEA Form 107 instructions.docx apps.deadiversion.usdoj.gov/TLR/	Instruction
DEA Form 106 Report of Theft and Loss of Controlled Substances TLR Online User Manual 1.0.pdf apps.deadiversion.usdoj.gov/TLR/	Form and Instruction
DEA Form 106 Report of Theft and Loss of Controlled Substances TLR Online User Manual 1.0.pdf apps.deadiversion.usdoj.gov/TLR/	Form and Instruction
DEA Form 107 Report of Theft or Loss of Listed Chemical DEA107v2.0 7-21-17.pdf apps.deadiversion.usdoj.gov/TLR/	Form
DEA Form 107 Report of Theft or Loss of Listed Chemical DEA107v2.0 7-21-17.pdf apps.deadiversion.usdoj.gov/TLR/	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 1310.05 21 CFR 1301.74

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DEA Form 106	https://apps.deadiversion.usdoj.gov/TLR/	Yes	Yes	Fillable Fileable Signable
Instruction		https://apps.deadiversion.usdoj.gov/TLR/	Yes	Yes	Fillable Printable
Form	DEA Form 107	https://apps.deadiversion.usdoj.gov/TLR/	Yes	Yes	Fillable Fileable Signable

Line of Business: Law Enforcement

Subfunction: Substance Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,547

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	32,644	-4,403	37,047
Annual IC Time Burden (Hours)	10,881	-1,467	12,348
Annual IC Cost Burden (Dollars)	0	0	0

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.

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