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URL: | https://www.deadiversion.usdoj.gov/imp_exp/161/form-161.html |
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Modified: | 2024-05-29 08:47:24 |
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Title: | Diversion Control Division | DEA Form 161 |
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Keywords: | Diversion Control Division |
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Body: | DIVERSION CONTROL DIVISION
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DEA Form 161
Home
Reporting
Import/Export Permit Applications and Declarations
DEA Form 161
DEA Form 161 - Application for Permit to Export Controlled Substances (PDF)
Instructions PDF
INFORMATION AND INSTRUCTIONS, DEA FORM 161
This application must be completed in triplicate. Original is sent to DEA.
See instruction 7 for copies two and three.
The name and address of the consignee as shown on this application
and on the permit to export must correspond with that shown on the foreign
import certificate.
To avoid delays in clearance at the port of export be sure to enter
the correct port on this application. A copy of your export permit is sent
directly to the District Director of Customs at the port indicated on the
application for comparison with the permit presented for clearance of the
shipment. The shipment will not clear at any other port without an
amendment of the permit indicating a change to that effect.
The original or an authentic signed and/or notarized copy of the
foreign import certificate must accompany this application. If this
certificate is needed to accomplish entry of the drug into the country of
destination, your request for its return to you should accompany the
application.
Application should be made in the name of the registered legal
entity, as shown on the DEA registration certificate, and signed by a
responsible authorized official if a corporation, by a partner, or by the
person registered as an individual. Only persons registered as exporters or
as analytical laboratories may be issued export permits. The registrations
of manufacturers, distributors, practitioners, researchers, etc., do not
entitle them to export controlled substances.
Permits will be mailed to the exporter at the address shown at the
bottom of the application unless contrary instructions are attached to and
made a part of this application.
Identification of drugs to be exported and the controlled substance
content should be entered on the application in the following manner:
7a. NAME AND QUANTITY OF DRUG OR
PREPARATION TO BE EXPORTED 7b. CONTROLLED SUBSTANCE CONTENT OF
DRUG OR PREPARATION TO BE EXPORTED
(expressed as acid, base or alkaloid, not salt)
3 bottles x 100 Secobarbital Sodium capusules
(100 mg./capsule) secobarbital 27.47 gm
2 boxes x 100 Meperidine HCl ampules (5%, 2
ml. ampules) meperidine 17.43 gm
1 box x 100 Meperidine HCl vials (10%, 20 ml.,
vials) meperidine 174.30 gm
2 x 1 Pt. Meperidine HCl Syrup (50 mg./5 ml.,
pints) meperidine 8.24 gm
1 box x 100 gm. Detroamphetamine Sulfate
powder dextroamphetamine 73.38 gm
1 bottle x 500 Hydromorphone HCl tablets (4
mg./tablets) hydromorphone 1.77 gm
The following information must be entered in block 7c at the time of
export: (1) DEA Export Permit Number and (2) actual quantity and date
shipped. Copy 2 is sent to DEA, and Copy 3 is retained by the registrant.
PRIVACY ACT INFORMATION
Authority: Section 1003 of the Controlled Substances Act of 1970 (PL
91-513).
Purpose: Control exportation of certain Controlled Substances into the
United States.
Routine Uses: The Controlled Substances Act Registration Records produces
special reports required for statistical analytical purposes. Disclosures
of information from this system are made to the following categories of
users for the purposes stated:
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.
Persons registered under the Controlled Substances Act (Public Law 91-513)
for purposes of verifying the registration of customers and practitioners.
Effect: No permit will be issued.
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 15 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
reducing this burden, to the FOI and Records Management Section, Drug
Enforcement Administration, Washington, D.C. 20537; and to the Office of
Management and Budget, Paperwork Reduction Project No. 1117-0004,
Washington, D.C. 20503.
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DIVERSION CONTROL DIVISION
U.S. Department of Justice
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DIVERSION CONTROL DIVISION
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1.800.882.9539
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