Import/Export Declaration for List I and List II Chemicals (Year)

INSTRUCTIONS FOR COMPLETING DEA FORM-486
The DEA Form-486 is used to notify the DEA of all imports, exports, and international transactions (except imports of ephedrine, pseudoephedrine, and
phenylpropanolamine, which requires DEA Form-486A) as required by the Controlled Substances Import and Export Act (21 U.S.C. 971). The following
instructions supplement the parts of the DEA Form 486 that are not completely self-explanatory. Detailed requirements are found in Title 21 CFR Parts 1300,
1310 and 1313.
Section 1a must always be the importer, exporter, or broker/trader located in the United States. Section 1b must be the customs broker/forwarding agent for
imports into and exports from the United States. If this form is used for an international shipment, the foreign importer must be listed in Section 1b.
Section 1c should be checked if the registrant has regular importer status or regular customer status.
Section 2. Example 1:

2a. HELIOTROPIN

Example 2*: 2a. COUGH & COLD

2b. PIPERONAL
CHEMICAL CODE 8750

2c. 80 DRUMS X 100 KG/DRUM = 8,000 KG

2b. PSEUDOEPHEDRINE HCL
CHEMICAL CODE 8112

2c. 500 BOTTLES X 100 TABLETS/BOTTLE X
30 MG/TABLET X 0.8192 (conversion factor**) =
1,228,800 MG = 1.2288 KG

*Example 2 is for a U.S. export. U.S. imports of Ephedrine, Pseudoephedrine, and Phenylpropanolamine must be submitted on a DEA Form-486A.
**The DEA registrant should check the DEA Diversion webpage “www.deadiversion.usdoj.gov/quotas/conv_factor/index.html” to find the conversion factor of
the listed chemical if it contains a salt (ex. HCl, sulfate, tartrate).
2d. Return Information: For imports, the importer must provide the date and weight (base) of the listed chemical that arrived at their registered location. For
exports, the exporter must provide the date and weight (base) of the listed chemical that departed from their registered location. If available, the importer/exporter
must provide the date and weight (base) of the listed chemical released by U.S. Customs and Border Protection (CBP). For international shipments, the broker or
trader must provide the date and weight (base) of the listed chemical that arrived at the importers (foreign transferee) location.
Section 3. If this form is prepared as an Import Declaration, list the foreign port of export (port name, city, country) from where the shipment will depart the country
of export and the anticipated date it will depart in section 3a. In section 3b, list the U.S. port of import (port name, city, state) and the anticipated date it will arrive.
If this form is prepared as an Export Declaration, list the U.S. port of export (port name, city, state) from where the shipment will depart the United States and the
anticipated date it will depart in section 3a. In section 3b., list the foreign port of import (port name, city, country) and the anticipated date it will arrive.
If this form is prepared as an International Declaration, list the foreign port of export (port name, city, country) from where the shipment will depart and the
anticipated date it will depart in section 3a. In section 3b., list the foreign port of import (port name, city, country) and the anticipated date it will arrive.
Section 5. If this form is prepared as a Import Declaration, enter the name and address of the foreign consignor. If this form is prepared as a Export Declaration,
enter the name and address of the foreign consignee, the foreign import permit number and its date of issue and expiration. If this form is prepared as an
International Declaration, enter the name and address of the foreign consignor.
Page 2 is only required for imports into the United States. Complete 6a and 6b for the first transferee. Complete 7a and 7b for the second transferee. Complete 8a
and 8b for the third transferee. Use a seperate page 2 for additional transferees. Per Title 21 CFR § 1313.16, transferee means a person to whom an importer
transfers a listed chemical.
The importer must provide Return Information for each distribution to each transferee listed on page 2 (6c, 7c, 8c) within 30 days of the distribution. If the importer
has not distributed all of the listed chemical imported by the end of the initial 30 day period, the importer must file supplemental return information no later than 30
days from the date of any further distributions until all of the listed chemical imported is account for.
INSTRUCTIONS FOR DISTRIBUTING DEA FORM-486
The importer or exporter, or their agent, must submit an official record of the import or export declaration and/or required data concerning the import or export
transaction to a customs officer at the port of entry or export in compliance with all import or export control requirements of agencies with import or export control
authorities under the Act or statutory authority other than the Controlled Substances Import and Export Act. See 21 CFR § 1313.14 (imports) and §1313.23
(exports).
PRIVACY ACT INFORMATION
AUTHORITY: Sections 1018 of the Controlled Substances Import and Export Act.
PURPOSE: To obtain information regarding the importation and exportation of certain chemicals to prevent the illicit manufacture of controlled substances.
ROUTINE USES: The Import/Export Declaration for List i and List II Chemicals produces information required for law enforcement purposes. Disclosure of
information is made to the following categories of users for the purposes stated:
A. Other Federal law enforcement and regulatory agencies for law enforcement and regulatory purposes
B. State and local law enforcement and regulatory agencies for law enforcement and regulatory purposes
C. Persons registered under the Controlled Substances Act (P.L. 91-513) for the purpose of verifying the registration of customers
EFFECT: Failure to complete this form will preclude requested importation or exportation of the referenced controlled substances.
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 12 minutes per response for export and international transactions,15 minutes per
response for imports, and 5 minutes per response for Return Information, 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 Drug Enforcement Administration, FOI and Records Management Section,
8701 Morrissette Drive, Springfield, VA 22152; and to the Office of Management and Budget, Paperwork Reduction Project No. 1117-0023, Washington, D.C.
20503.