**This is a generic form which may be used if your state does not require a specific format.**

Generic Pseudoephedrine Registers are printed on high quality 28lb opaque paper and are permanently bound along the top edge.

• Includes items required by the Federal law: Date & Time Sold, Exempt Preparation, Quantity, Purchaser’s Name, Purchaser’s Signature,
  Purchaser’s Address, Type of Photo ID, and Dispensed By
• Each sheet is numbered to show that no pages are missing.
• 25 sheets (50 pages) per book
• Books lie flat for easy use
• Books are 8 ½ x 11

*This format was developed by Covap Inc.  It is meant to be a reasonable way of recording Pseudoephedrine sales but is not authorized by any governing body.