Fillable MDAR - Industrial Hemp Planting Report

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MDAR - Industrial Hemp Planting Report

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Last update: 11 March 2019
T
HE
C
OMMONWEALTH
O
F
M
ASSACHUSETTS
EXECUTIVE OFFICE OF ENERGY AND ENVIRONMENTAL AFFAIRS
Department of Agricultural Resources
251 Causeway Street, Suite 500, Boston, MA 02114
617-626-1700 fax: 617-626-1850 www.mass.gov/agr
Industrial Hemp Planting Report
All planting forms must be submitted no later than ten (10) days after planting
Directions
Complete all parts of the following application and submit to the Department, including any required
attachments no later than ten (10) days after planting. Your hemp may only be planted within a licensed
growing area. You may NOT plant hemp in any unlicensed areas. To add growing area to your license, you
MUST submit a revision to the program for prior approval.
N
OTE: Crop transplanting does NOT need to be reported to the Department separately as long as the crop is
being transplanted to a licensed area, and the crop has already been reported to the Department.
NOTE: A copy of the seed certification(s) demonstrating that the varieties or cultivars planted are not above
the allowable 0.3% THC limit must have been previously submitted to the Department.
Mail to: Massachusetts Department of Agricultural Resources
Hemp Program
251 Causeway Street; Suite 500
Boston, MA 02114
Attn: Sarah Grubin
or email:
sarah.grubin@mass.gov
Please type or print clearly (incomplete or illegible forms will be returned).
License Holder Information
Name of License Holder:
MDAR License no:
Mailing Address:
Primary Phone:
☐
cell
☐
home
☐
office
Email:
Planting Area Detail
Please provide the following information for each site to be planted. If there is more than one licensed site to be planted, please fill out
additional Planting Forms for each.
Site Name:
Physical Address:
City: State: Zip Code:
Longitude:
Page 2 of 2
MA Industrial Hemp Planting Report
Ea
ch variety is considered a separate crop. Please list each planting individually by crop. Attach additional
sheets as necessary.
Planting Information
Grow Area Name Variety/Strain Planting type Amount Planted Planting Date
Expected
Harvest Date
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
seeds clones
acres
ft
2
#plants
Official Use Only
Date Received:
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Completed 11 May 2020

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