Get the free DEA Form 486 - Import / Export Declaration for List I and List II ... - deadiversion...

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How to fill out dea form 486

How to fill out DEA Form 486:

1. Begin by visiting the DEA's website to access the official DEA Form 486. This form is used by pharmacies, hospitals, and other registered dispensers to report thefts or significant losses of controlled substances.
2. Fill in the "Date Prepared" field with the current date.
3. In the "Registrant's Name" section, provide the name of the registered entity or individual that is reporting the theft or loss.
4. Enter the "DEA Registration Number" associated with the registered entity or individual.
5. Provide the "Business Address" of the registered entity, including the street address, city, state, and zip code.
6. Insert the "Name and Telephone Number of Person to Contact for Additional Information" in the designated fields.
7. In the "1. Date and Time of Discovery of Theft or Loss" section, specify the date and time when the theft or loss was discovered.
8. Describe the exact "Location Where Theft or Loss Occurred." Include the complete address, including any relevant details such as room numbers or storage areas.
9. Indicate whether the theft or loss occurred during regular business hours or outside of these hours.
10. Use the "2. Description of Theft or Loss" section to provide a detailed account of what was stolen or lost. Include specific information such as the name and strength of the controlled substances, quantities, and any distinguishing characteristics.
11. Detail the events surrounding the theft or loss in the "3. Circumstances of Theft or Loss" section. Explain how the incident was discovered, any suspicious activities, or any other relevant information.
12. If any controlled substances were recovered or found, provide details in the "4. Umber of Losses or Thefts Involving Recovered Controlled Substances Since the Last Report" section.
13. If the authorities were notified or involved, specify the "5. Notification to Other Agencies" and provide information on the agencies contacted.
14. The "6. Reporting Person/Phone Number/DEA Number" section requires the information of the person filling out the form. Provide the name, phone number, and DEA number.
15. Finally, review the form to ensure all the necessary information is accurately provided. Sign and date the form before submitting it to the appropriate DEA office.

Who needs DEA Form 486:

1. Pharmacies: Pharmacies that are registered with the DEA and experience thefts or significant losses of controlled substances need to use DEA Form 486 to report these incidents.
2. Hospitals: Similarly, hospitals that are registered with the DEA and encounter thefts or significant losses of controlled substances are required to complete DEA Form 486 as a means of reporting the incidents.
3. Registered Dispensers: Any registered dispenser, such as nursing homes, clinics, or other healthcare facilities, that faces thefts or significant losses of controlled substances must utilize DEA Form 486 to report the occurrences.

It is important to note that DEA Form 486 should only be completed by individuals or entities that are registered with the DEA and are authorized to handle controlled substances.

For pdfFiller’s FAQs

What is dea form 486?

DEA Form 486 is a form used to report the quantity of controlled substances distributed by a registrant to other registrants or practitioners. It is also known as the Controlled Substances Quota for manufacturers.

Who is required to file dea form 486?

Manufacturers, distributors, importers, and exporters of controlled substances are required to file DEA Form 486.

How to fill out dea form 486?

DEA Form 486 can be filled out electronically on the DEA's Diversion Control Division website. Registrants must provide information on the controlled substances being distributed, the quantity, and the destination.

What is the purpose of dea form 486?

The purpose of DEA Form 486 is to ensure that controlled substances are distributed in a responsible and legal manner, and to monitor the flow of these substances within the supply chain.

What information must be reported on dea form 486?

The information reported on DEA Form 486 includes the name and address of the registrant, the controlled substances being distributed, the quantity, and the destination of the substances.

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