DEA Form 224 - New Application for Registration
- Section 1 - Application Identification
- Section 2 - Business Activity
- Section 3 - Drug Schedules
- Section 4 - State License(s)
- Section 5 - Liability
- Section 6 - Certification of Exemption
- Section 7 - Method of Payment
- Section 8 - Applicant's Signature
- Notice of Registrants Making Payment by Check
- Additional Information
- Contact Information
Information must be typed or printed in the blocks provided to help reduce data entry errors. A physical address is required in address line 1; a post office box or continuation of address may be entered in address line 2. Fee exempt applicant must list the address of the federal or state fee exempt institution.
Applicant must enter a valid social security number (SSN), or a tax identification number (TIN) if applying as a business entity. Debt collection information is mandatory pursuant to the Debt Collection Improvement Act of 1996
The email address, point of contact, national provider id, date of birth, year graduated, and professional school are new data items that are used to facilitate communication or as required by inter-agency data sharing requirements. They are requested in order to facilitate communication or as required by inter-agency data sharing requirements.
Practitioner must enter one degree from this list: DDS, DMD, DO, DPM, DVM, or MD.
Mid-level practitioner must enter one degree from this list: DOM, HMD, MP, ND, NP, OD, PA, or RPH.
Indicate only one. Practitioner or mid-level practitioner must enter the degree conferred, and are requested to enter the last professional school of matriculation and the year graduated.
Automated dispensing system (ADS) must provide current DEA registration number of parent retail pharmacy or hospital, and attach a notarized affidavit in accordance with 21 CFR Part 1301.17. Affidavit must include:
- Name of parent retail pharmacy or hospital and complete address
- Name of Long-term Care (LTC) facility and complete address
- Permit or license number(s) and date issued of State certification to operate ADS at named LTC facility
- Required Statement:
This affidavit is submitted to obtain a DEA registration number. If any material information is false, the Administrator may commence proceedings to deny the application under section 304 of the Act (21 U.S.C. 8224(a)). Any false or fraudulent material information contained in this affidavit may subject the person signing this affidavit, and the named corporation/partnership/business to prosecution under section 403 of the Act (21 U.S.C 843).
- Name of corporation operating the retail pharmacy or hospital
- Name and title of corporate officer signing affidavit
- Signature of authorized officer
Applicant should check all drug schedules to be handled. However, applicant must still comply with state requirements; federal registration does not overrule state restrictions. Check the order form box only if you intend to purchase or to transfer schedule 2 controlled substances. Order forms will be mailed to the registered address following issuance of a Certificate of Registration. The following list of drug codes are examples of controlled substances for narcotic and non-narcotic schedules 2, 3, 4, and 5. Refer to the CFR for a complete list of basic classes.
NARCOTIC BASIC CLASSES CODE Alphaprodine (Nisentil) 9010 Anileridine (Leritine) 9020 Cocaine (Methyl Benzoylecgonine) 9041 Codeine (Morphine methyl ester) 9050 Dextropropoxyphene (bulk) 9273 Diphenoxylate 9170 Diprenorphine (M50-50) 9058 Ethylmorphine (Dionin) 9190 Etorphine Hydrochloride (M-99) 9059 Glutethimide (Doriden, Dorimide) 2550 Hydrocodone (Dihydrocodeinone) 9193 Hydromorphone (Dialudid) 9150 Levo-alphacetylmethadol (LAAM) 9648 Levorphanol (Levo-Dromoran) 9220 Meperidine (Demerol, Mepergan) 9230 Methadone (Dolophine, Methadose) 9250 Morphine (MS Contin, Roxanol) 9300 Opium, powdered 9639 Opium, raw 9600 Oxycodone (Oxycontin, Percocet) 9143 Oxymorphone (Numorphan) 9652 Opium Poppy / Poppy Straw 9650 Poppy Straw Concentrate 9670 Thebaine 9333 NON-NARCOTIC BASIC CLASSES CODE Amobarbital (Amytal, Tuinal) 2125 Amphetamine (Dexedrine, Adderall) 1100 Methamphetamine (Desoxyn) 1105 Methylphenidate (Concerta, Ritalin) 1724 Pentobarbital (Nemutal) 2270 Phencyclidine (PCP) 7471 Phenmetrazine (Preludin) 1631 Phenylacetone 8501 Secobarbital (Seconal) 2315
NARCOTIC BASIC CLASSES CODE Buprenorphine (Buprenex, Temgesic, Subutex 9064 Codeine combo product up to 90 mg/du (Empirin) 9804 Dihydrocodeine combo prod 90 mg/du (Compal) 9807 Ethylmorphine combo product 15 mg/du 9808 Hydrocodone combo product (Lorcet, Vicodin) 9806 Morphine combo product 50 mg/100ml or gm 9810 Opium combo product 25 mg/du (Paregoric) 9809 NON-NARCOTIC BASIC CLASSES CODE Anabolic Steroids 4000 Benzphetamine (Didrex, Inapetyl) 1228 Butalbital (Fiorinal, Butalbital w/aspirin) 2100/2165 Dronabinol in sesame oil w/soft gelatin capsule 7369 Gamma Hydroxybutyric Acid preps (Zyrem) 2012 Ketamine (Ketaset) 7285 Methyprylon (Noludar) 2575 Pentobarbital suppository du & noncontrolled active ingred. (FP-3, WANS) 2271 Phendimetrazine (Plegine, Bontril, Statobex 1615 Secobarbital suppository du & noncontrolled active ingredients 2316 Thiopental (Pentothal) 2100/2329 Vinbarbital (Delvinal 2100/2329
BASIC CLASSES CODE Alprzolam (Xanax) 2882 Barbital (Veronal, Plexonal, Barbitone) 2145 Chloral Hydrate (Noctec) 2465 Chlordiazepoxide (Librium, Libritabs) 2744 Clorazepate (Tranxene) 2768 Dextropropoxyphene du (Darvon) 9278 Diazepam (Valium, Diastat) 2765 Diethylpropion (Tenuate, Tepanil) 1610 Difenoxin 1mg/25ug atropine SO4/du (Motofen) 9167 Fenfluramine (Pondimin, Dexfenfluramine) 1670 Flurazepam (Dalmane) 2767 Halazepam (Paxipam) 2762 Lorazepam (Ativan) 2885 Mazindol (Sanorex, Mazanor) 1605 Mebutamate (Capla) 2800 Meprobamate (Miltown, Equanil) 2820 Methohexital (Brevital 2264 Methylphenobarbital (Mebaral) 2250 Midazolam (Versed) 2884 Oxazepam (Serax, Serenid-D)) 2835 Paraldehyde (Paral) 2585 Pemoline (Cylert) 1530 Pentazocine (Talwin, Talacen) 9709 Phenobarbital (Luminal, Donnatal) 2285 Phentermine (Ionamin, Fastin, Zantryl) 1640 Prazepam (Centrax) 2764 Quazepam (Doral) 2881 Temazepam (Restoril) 2925 Triazolam (Halcion) 2887 Zolpidem (Ambien, Ivadal, Stilnox) 2783
BASIC CLASSES CODE Codeine Cough Preparation (Cosanyl, Pediacof) 9050 Difenoxin Preparation (Motofen) 9167 Dihydrocodeine Preparation (Cophene-S) 9120 Diphenoxylate Preparation (Lomotil, Logen) 9170 Ethylmorphine Preparation 9190 Opium Preparation (Kapectolin PG) 9809
Federal registration by DEA is based upon the applicant 's compliance with applicable state and local laws. Applicant should contact the local state licensing authority prior to completing this application. If your state requires a separate controlled substance number, provide that number on this application.
Applicant must answer all four questions for the application to be accepted for processing. If you answer "Yes" to a question, provide an explanation in the space provided. If you answer "Yes" to several questions, then you must provide a separate explanation describing the date, location, nature, and result of incident. If additional space is required, you may attach a separate page.
Exemption from payment of application fee is limited to federal, state or local government official or institution. The applicant's superior or agency officer must certify exempt status. The signature, authority title, and telephone number of the certifying official (other than the applicant) must be provided. The address of the fee exempt institution must appear in Section 1.
Indicate the desired method of payment. Make checks payable to "Drug Enforcement Administration". Third-party checks or checks drawn on foreign banks will not be accepted. FEES ARE NON-REFUNDABLE.
Applicant MUST sign in this section or application will be returned. Card holder signature in section 7 does not fulfill this requirement.
Authorization to Convert Your Check: If you send us a check to make your payment, your check will be converted into an electronic fund transfer. "Electronic fund transfer" is the term used to refer to the process in which we electronically instruct your financial institution to transfer funds from your account to our account, rather than processing your check. By sending your completed, signed check to us, you authorize us to copy your check and to use the account information from your check to make an electronic fund transfer from your account for the same amount as the check. If the electronic fund transfer cannot be processed for technical reasons, you authorize us to process the copy of your check.
The electronic funds transfer from your account will usually occur with 24 hours, which is faster than a check is normally processed. Therefore, make sure there are sufficient funds available in your checking account when you send us your check. If the electronic funds transfer cannot be completed because of insufficient funds, we may try to make the transfer up to two more times.
The electronic fund transfer from your account will be on the account statement you receive from your financial institution. However, the transfer may be in a different place on your statement than the place where your checks normally appear. For example, it may appear under "other withdrawals" or "other transactions." You will not receive your original check back from your financial institution. For security reasons, we will destroy your original check, but we will keep a copy of the check for record-keeping purposes.
You should contact your financial institution immediately if you believe that the electronic fund transfer reported on your account statement was not properly authorized or is otherwise incorrect. Consumers have protections under Federal law called the Electronic Fund Transfer Act for an unauthorized or incorrect electronic fund transfer.
No registration will be issued unless a completed application has been received (21 CFR 1301.13).
In accordance with the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless it displays a valid OMB control number. The OMB number for this collection is 1117-0014. Public reporting burden for this collection of information is estimated to average 12 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information.
The Debt Collection Improvements Act of 1996 (31 U.S.C. §7701) requires that you furnish your Taxpayer Identification Number (TIN) or Social Security Number (SSN) on this application. This number is required for debt collection procedures if your fee is not collectible.
PRIVACY ACT NOTICE: Providing information other than your SSN or TIN is voluntary; however, failure to furnish it will preclude processing of the application. The authorities for collection of this information are §§302 and 303 of the Controlled Substances Act (CSA) (21 U.S.C. §§822 and 823). The principle purpose for which the information will be used is to register applicants pursuant to the CSA. The information may be disclosed to other Federal law enforcement and regulatory agencies for law enforcement and regulatory purposes, State and local law enforcement and regulatory agencies for law enforcement and regulatory purposes, and persons registered under the CSA for the purpose of verifying registration. For further guidance regarding how your information may be used or disclosed, and a complete list of the routine uses of this collection, please see the DEA System of Records Notice "Controlled Substances Act Registration Records" (DEA-005), 52 FR 47208, December 11, 1987, as modified.
TELEPHONE: HQ Call Center (800) 882-9539
WRITTEN INQUIRIES: DEA, Attn: Registration Section/ODR, P.O. Box 2639, Springfield, VA 22152-2639.
All offices are listed on web site (800, 877, and 888 are toll-free)