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Import
Export > DEA Form 357 - Application for Permit to Import
Controlled Substances for Domestic and/or Scientific Purposes
DEA FORM 357
The application
or declaration listed below is
available in PDF format in two ways – 1. As an interactive form
which can be completed on-line 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 on-line and then
printed.
INFORMATION AND INSTRUCTIONS, DEA-357
This application must be completed in triplicate. Original
is sent to DEA. See instruction 6c for copies
two and three.
Importation of any controlled substance listed in schedule
I or II or any narcotic drug listed in schedule
III, IV, or V should be made pursuant to 21
CFR, Section
1312.13, parts (a) and (b) or any schedule III
through V nonnarcotic controlled substance as specifically
designated by 21
CFR, Section
1312.30.
Permits when issued will be mailed to the importer at the
address shown on the application unless
contrary instructions are received. Application should be
made in the name of the official whose
registration is on file with the Drug Enforcement
Administration.
6. Identification of drugs to be imported and the
controlled substance content should be entered on the application in the
following manner:
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6a. NAME AND QUANTITY OF DRUG OR
PREPARATION TO BE IMPORTED AND
NUMBER OF CONTAINERS
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6b. CONTROLLED SUBSTANCE CONTENT OF DRUG
OR PREPARATION TO BE IMPORTED (expressed
as acid, base or alkaloid, not salt)
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| 1 Vial x 0.1 mg Cocaine d3 |
Cocaine 0.1 mg
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1 vial x 5.0 mg Phen-d5-cyclidine HC1
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Phencyclidine
4.35
mg
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250 Cases containing a total of 15,100 kg Crude Indian Opium (10% AMA)
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Opium 1,500 kg AMA
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3,600 kg Poppy Straw Concentrate 75-80% AMA
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Poppy Straw Concentrate
2,700-2,800 kg AMA
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6c. The following information must be entered in block 6c
of copies 2 and 3 at the time of import:
(1) DEA Import Permit No. and (2) actual quantity and date
received. Copy 2 is sent to DEA.
Copy 3 is retained by importer.
7. Importers of crude opium, poppy straw, concentrate of
poppy straw, and coca leaves complete this section.
8. If applicable, the scientific uses to which the drug is
to be put after import should be stated briefly, such as:
"For chemical and clinical study of its properties
and suitability for medical distribution."
"For use in laboratory and pilot plant studies of
methods of extraction (or production) of its
component alkaloids." Etc.
PRIVACY ACT INFORMATION
Authority: Section 1002 of the Controlled Substances
Act of 1970 (PL 91-513).
Purpose: Control importation 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:
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Other Federal law enforcement and regulatory agencies
for law enforcement and regulatory purposes.
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State and local law enforcement and regulatory agencies
for law enforcement and regulatory purposes.
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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. 1117-0013,
Washington, D.C. 20503.
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