Dea form 106 2025

1. Click ‘Get Form’ to open DEA Form 106 in the editor.
2. Begin by selecting the type of report you are filing. Check either 'New Report' or 'Amendment' and provide the prior report date if applicable.
3. Fill in your DEA Registration Number, business name, address, city, state, ZIP code, point of contact, email address, and phone number.
4. Indicate the date of theft or loss and the number of thefts/losses in the past 24 months.
5. Select your principal business type from options such as Pharmacy, Practitioner, Manufacturer, etc.
6. If applicable, complete the section for loss in transit by providing details about the common carrier and tracking number.
7. Answer questions regarding injuries during robbery and whether police were notified. Include police department details if applicable.
8. List corrective measures taken to prevent future incidents and provide a detailed description of any other relevant information.
9. Finally, sign and date the form electronically to certify that all information is accurate before submitting it.

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