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DEA Form 104 - Voluntary Surrender of Controlled Substance Privileges


More and more often the DEA's first question upon entry of a registrant's premises for inspection is, "Are you prepared to voluntarily surrender your registration?". You should consider this information before you sign DEA Form 104. The execution of this form will result in the immediate loss of prescribing or dispensing privileges for the registrant. It also likely means the registrant and its principals will not be permitted to become registrants in the future.

Registrants should not execute From 104 without consultation with an attorney familiar with the DEA regulations and proceedings. Pursuant to 21 CFR §1301.52(a) the surrender is effective immediately upon receipt by a DEA employee. That means if a registrant signs the form and hands it to the requesting Diversion Investigator or DEA Special Agent, they will not be given the opportunity to reconsider or retract the surrender. It is for this reason we recommend that you decline a request to surrender unless or until you have been advised of all of the consequences of this action.

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