Office of Diversion Control, US Department of Justice, Drug Enforcement Administration

REPORTING > Reports Required by 21 CFR > Inventory of Drugs Surrendered - DEA Form 41

Inventory of Drugs Surrendered - DEA Form 41

Destruction of Controlled Substances

IMPORTANT NOTICE: Only those persons registered with and authorized by DEA to handle controlled substances may utilize/submit this form.

The instructions provided on the DEA Form 41 are incorrect. Please disregard instruction number 5. That instruction directs the registrant to ship the drugs to the Special Agent in Charge of the DEA office that serves the registrant's area. Registrants should send the forms to DEA as detailed in instruction number 3, and await instructions on how to proceed.

Currently the DEA Form 41 (Registrants Inventory of Drugs Surrendered) is available in PDF format in two ways – 1. As an interactive form which can be completed online and printed on your printer, or 2. As a blank form to be printed on your printer. This second version is not recommended; fewer errors occur if the form is entered online and then printed.

This PDF form will print out both the front and back of the official forms.


INSTRUCTIONS
DEA Form 41 Registrants Inventory of Drugs Surrendered

  1. DO NOT SEND DRUGS TO ANY DRUG ENFORCEMENT ADMINISTRATION (DEA) OFFICE WITHOUT PRIOR WRITTEN APPROVAL. Drugs are to be destroyed by: (1) shipment to a reverse distributor registered by DEA (may not require the use of this form); (2) the registrant, according to state and local laws, rules and regulations; or (3) the specific instructions of your area Drug Enforcement Office.
  2. List the name of the drug in column 1, the number of containers in column 2, the size of each container in column 3, and in column 4 the controlled substance content of each unit described in column 3; e.g., morphine sulfate tabs., 3 pkgs., 100 tabs., 1/4 gr. (16 mg.) or morphine sulfate tabs., 1 pkg., 83 tabs., 1/2 gr. (32mg.), etc.
  3. All packages included on a single line should be identical in name, content and controlled substance strength.

Privacy Act Information for DEA Form 41

Authority: Section 307 of the Controlled Substances Act of 1970 (PL-513).
Purpose: To document the surrender of controlled substances which have been forwarded by registrants to DEA for disposal.
Routine Uses: This form is required by Federal Regulations for the surrender of unwanted Controlled Substances. Disclosures of information from this system are made to the following categories of users for the purposes stated:
  1. Other Federal law enforcement and regulatory agencies for law enforcement and regulatory purposes.
  2. State and local law enforcement and regulatory agencies for law enforcement and regulatory purposes.
Effect: Failure to document the surrender of unwanted Controlled Substances may result in prosecution for violation of the Controlled Substances Act.

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 30 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 this burden, to the Drug Enforcement Administration, FOI and Records Management Section, Washington, D.C. 20537; and to the Office of Management and Budget, Paperwork Reduction Project no. 1117-0007, Washington, D.C. 20503.

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U.S. DEPARTMENT OF JUSTICE  •  DRUG ENFORCEMENT ADMINISTRATION
Office of Diversion Control  •  8701 Morrissette Drive  •  Springfield, VA 22152  •  1-800-882-9539