Information Collection

Registrants Inventory of Drugs Surrendered--DEA Form 41

IC 12289 under ICR 202401-1117-001 · OMB 1117-0007.

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 DEA Form 41 41_form.pdf www.DEAdiversion.usdoj.gov	Form
41 DEA Form 41 41_form.pdf www.DEAdiversion.usdoj.gov	Form
2012.05.07 - Modified DEA Form 41 (clean) (1).pdf DEA 41 Clean	IC Document
2012.05.07 - Modified DEA Form 41 (clean) (1).pdf DEA 41 Clean	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 1314

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	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: Controlled Substances Act Registration Records (CSA

FR Citation: 82 FR 24147

Number of Respondents: 92,832

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	92,832	2,203	90,629
Annual IC Time Burden (Hours)	46,416	1,101	45,315
Annual IC Cost Burden (Dollars)	0	-1,008,425	1,008,425

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DEA 41 Clean	2012.05.07 - Modified DEA Form 41 (clean) (1).pdf	01/23/2024

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