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Get and Sign DEA Drug Questionnaire Dea Form
Used/Tried/Experimented Initials DEA Form 341 Rev. 4/2014 Name Opium LSD Ecstasy Any Other Illegal Tried/Experimented identify I certify that the information provided on this questionnaire is correct and complete to the best of my knowledge. OMB No. 1117-0043 EXP. DATE 8/31/2020 Previous editions obsolete DRUG QUESTIONNAIRE Privacy Act Notice Providing this information is voluntary. Signature of Applicant Date PAPERWORK REDUCTION ACT NOTICE See Title 44 United States Code Chapter 35. The...
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