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Drug Enforcement Administration / Government


Special Agent Applicant Drug Use Statement Privacy Act Statement Authority: Title 5, U.S. Code, Sections 301 and 1104; and Executive Order 12564, September 15, 1986. Principal Purpose: This form requests information abou
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Document Date: 2014-03-13 16:39:44


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Country

United States / /

IndustryTerm

chemicals / local law enforcement / /

Organization

Drug Enforcement Administration / Last____________________ First___________________ Middle___________ Division / Drug Use Statement Privacy Act Statement Authority / /

Person

Purpose / /

Position

Special Agent / licensed physician / /

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