Fillable Form Instructions: Marijuana Applicant Questionnaire (Oregon)

Fill Online, Printable, Fillable, Blank Form Instructions: Marijuana Applicant Questionnaire (Oregon) Form

Use Fill to complete blank online OREGON pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form Instructions: Marijuana Applicant Questionnaire (Oregon)

On average this form takes 8 minutes to complete

The Form Instructions: Marijuana Applicant Questionnaire (Oregon) form is 2 pages long and contains:

  • 1 signature
  • 0 check-boxes
  • 27 other fields

Country of origin: US
File type: PDF

BROWSE OREGON FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Marijuana Applicant Questionnaire
Form Instructions
Marijuana Applicant Questionnaire Instructions Revised 20201015
What is this form?
Use this form to provide OLCC with a complete list of individuals and legal entities (e.g. LLC, corporation, limited
partnership, limited liability partnership, trust, sole proprietor) who are applicants for your marijuana license. As part of our
efforts to streamline the licensing process, OLCC is no longer routinely collecting detailed business structure information
prior to issuing the license.
Failure to completely and accurately disclose every individual and legal entity who is an applicant for this license may
constitute grounds to deny or revoke a license.
How do I know who is an applicant for the license?
It is your responsibility to read and understand the rules and correctly identify each individual and entity who qualifies as
an “applicant” as described in OAR 845-025-1045. OLCC has provided Guidance on Disclosing Interests in a
Recreational Marijuana Business to help businesses understand the rules and their obligations under the rules.
As described in OAR 845-025-1045, “applicant” includes any individual or legal entity who holds or controls a direct or
indirect interest of 20% or more in a recreational marijuana business, as well as any individual or entity who has an
“ownership Interest” in the business (see below). Both categories are considered the applicant(s) for a license, and will be
considered licensee(s) once a license is issued.
This includes any individual or legal entity entitled to receive 20% or more in revenue or profits from the business, whether
or not they are part of the proposed business itself. For example, a landlord receiving 20% or more in profits as part of a
rental agreement is considered an applicant.
“Ownership interest” is defined in OAR 845-025-1045 and includes:
Exercising control over, or having the right to exercise control over, the business. This includes having the right to
control access to the premises.
Incurring debt, entering into contracts, or entering into other similar obligations on behalf of the business.
Being named as a lessee of the proposed premises. If there is no lease, then the property owner is considered to
be an applicant for the license.
If an applicant is a legal entity, any individual or other legal entity who meets any of the following criteria is also
considered an applicant:
Managers of a manager-managed LLC
Principal officers of a corporation
General partners of a limited partnership
When legal entities own interests in other legal entities at multiple layers, those “nested” legal entities may also be
considered applicants depending on the percentage of ownership and role in the business. For example, an entity that
holds 50% ownership of a holding company that in turn holds 50% ownership in the business is considered to hold an
indirect ownership interest of 25% and would be an applicant for the license.
What other information may be required?
Each individual who is listed as an applicant must complete and sign an Individual History form that must be submitted as
part of the application.
OLCC may ask you to disclose your complete business structure in the future, but that information should not be listed on
this form.
OREGON LIQUOR CONTROL COMMISSION
Marijuana Applicant Questionnaire
[FORM MJ 20-1060] mj_app_applicants (20201015) Page 1 of 1
Section 1 – Business Information
Licensee Name:
Premises Address:
City:
State:
OR
ZIP:
Section 2 – Applicants
List every individual and legal entity who meets the qualifications of an “applicant” for this license, as
described in OAR 845-025-1045:
1.
11.
2.
12.
3.
13.
4.
14.
5.
15.
6.
16.
7.
17.
8.
18.
9.
19.
10.
20.
If there are more than 20 applicants, attach additional pages as needed
.
Section 3 – Acknowledgement
I affirm that, in Section 2, I have listed every natural person and legal entity who meets the qualifications
of an “applicant” for this business, as described in OAR 845-025-1045.
I understand that if my answers are not true and correct that the OLCC may deny my application.
Signature:
Date:
Name:
Title:
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form Instructions: Marijuana Applicant Questionnaire (Oregon)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document