Dea Power Of Attorney Form

Dea registration number s for which power of attorney is being granted a brief statement expressing that power of attorney for controlled substance ordering is being granted to the attorney in fact by an authorized party name and signature of the individual being granted power of attorney i e. D each dea form 222 must be signed and dated by a person authorized to sign an application for registration or a person granted power of attorney to sign a form 222 under 1305 05.

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The foregoing power of attorney is hereby revoked by the undersigned who is authorized to sign the current application for registration of the above named registrant under the controlled substances act or the controlled substances import and export act.

Dea power of attorney form. Address of registrant dea registration number i name of person granting power the undersigned who am authorized to sign the current application for registration of the above named registrant under the controlled substances act or controlled substances import and export act have made constituted and appointed and by these presents do make constitute and. Power of attorney for dea order forms name of registrant address of registrant dea registration number i name of person granting power the undersigned who is authorized to sign the current application for registration of the above named registrant under the controlled substances act or controlled substances. The name of the purchaser if different from the individual signing the dea form 222 must also be inserted in the signature space.

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