Fillable New York State Department of Agriculture and Markets (New York State)

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New York State Department of Agriculture and Markets (New York State)

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ANDREW M. CUOMO
Governor
RICHARD A. BALL
Commissioner
New York State Department of Agriculture and Markets
Grower Research Partner Application
Industrial Hemp Agricultural Research Pilot Program
The NYS Department of Agriculture and Markets is administering an Industrial Hemp Agricultural
Research Pilot Program, authorized by New York State law and 7 U.S.C. § 5940 (Farm Bill of 2014).
The Department is accepting applications from individuals or businesses interested in conducting
research relating to the growing of industrial hemp.
Due to a change in Federal Law, authorizations to grow hemp in New York State pursuant to
the authority cited above, will expire January 1, 2022.
Instructions
Read the Program Guidance and Sample Research Partner Agreement
to ensure that you understand
all the legal and programmatic requirements for participation in the Industrial Hemp Agricultural
Research Pilot Program.
Complete the following application, include all necessary attachments and the $500 non-refundable
application fee, and submit an original copy to:
NYS Department of Agriculture & Markets
Plant Industry Division
10B Airline Drive
Albany NY 12235
Incomplete applications, and applications without necessary attachments or fee, will be rejected.
All questions must be submitted in writing to industrialhempNYS@agriculture.ny.gov
or through the U.S.
mail to the address above.
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
2
This is a:
New application Renewal
1. Applicant.
2. Person Responsible for Applicant’s Management of Industrial Hemp Growing.
Address:
City:
State: Zip Code: County:
Email
Address:
Mailing address (if
different from above):
City: State: Zip Code: County:
Phone: ( )
Federal ID No.
Business/Institution Name:
Email Address:
Email Address:
Optional secondary contact:
Title:
Phone: ( )
Name:
SSN:
Address:
Title: Phone: ( )
Name:
SSN:
Address:
FOR OFFICE USE ONLY
Date received: _
Estab. No: License No.:
Credit Card Check M.O Receipt
Reviewed: Approved:
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
3
3. Growing/Drying Locations – List each field/greenhouse/drying location separately, even if
located at the same address. Attach additional sheets if necessary.
Submit with this application a map displaying site boundaries, nearby roadways, and access points of
each separate grow site
Site 1:
Outdoor acres OR Indoor square feet
Site name/ID: GPS Coordinates from center
of field in decimal format:
Address: ex. 42.734537, -73.817688
City: Latitude:
State: Zip Code: Longitude:
County:
I confirm that I have control over this property through:
Ownership Lease agreement
Site 2:
Outdoor acres OR Indoor square feet
Site name/ID: GPS Coordinates from center
of field in decimal format:
Address: ex. 42.734537, -73.817688
City: Latitude:
State: Zip Code: Longitude:
County:
I confirm that I have control over this property through:
Ownership Lease agreement
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
4
4. Experience. Please describe any relevant experience of Applicant as well as person(s) responsible for
industrial hemp in your organization.
5. Indicate the focus of your research (check all that apply).
6. Research plan. Explain in detail the industrial hemp research you are interested in conducting. Attach
additional sheets if necessary.
Fiber
Grain or food products (including hemp for seed oil)
Replication of seeds or vegetative planting stock (e.g. production of transplants)
CBD Hemp Growing
Other:
The Department is not accepting CBD processing applications.
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
5
7. Marketing Plan – Provide the name(s) of processor(s) to whom you will be selling your crop, if known.
Also include a letter of intent from the processor(s) that will be purchasing your hemp crop if applicable.
Attach additional sheets if necessary:
8. Seed/Propagule Acquisition Plan. Identify the varieties you intend to plant and list the source,
including address, of the industrial hemp seed/propagules for each variety.
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
6
9. Security Measures. Identify the steps that will be taken to ensure that industrial hemp and/or
products derived from industrial hemp are not acquired, possessed, grown or cultivated, harvested,
stored, transported, distributed or disposed of, except under conditions that ensure that it will not be
possessed or used in violation of requirements set forth in the Research Partner Agreement.
10. Felony. Has the person responsible for management of industrial hemp or any officer, director or
any stockholder exercising management of or control over the applicant been convicted of a felony
and/or drug-related misdemeanor in any court of the U.S. or any state or territory? Yes No
If yes, please explain:
INDUSTRIAL HEMP GROWER RESEARCH PARTNER APPLICATION
7
The undersigned applies for registration as an industrial hemp research partner pursuant to the
provisions of Article 29 of the Agriculture and Markets Law. The undersigned acknowledges that
the regulatory environment as it applies to industrial hemp is in flux and program guidance and
regulations are subject to change at any time.
I (We) agree to permit free entry and free access to the Commissioner and his agents to all
registered premises, buildings, and offices used in the cultivating, harvesting, transportation,
processing, studying, storing and disposing of industrial hemp. Yes
I (We) agree to maintain sites engaged in industrial hemp research in a manner that permits
ready inspection by the Department. Yes
I (We) understand that the issuance of a research authorization is conditioned upon the
execution of a Research Partner Agreement with the Department, which will be issued after
application review. Yes
I (we) understand that the authorization to grow hemp in New York State is pursuant to
7 U.S.C. § 5940 (Farm Bill of 2014) which expires January 1, 2022. Yes
I (We) agree to conform to the laws of the State of New York concerning the handling and
movement of industrial hemp and to related regulations of the Department currently in effect
or adopted subsequent to the issuance of a research permit. Yes
I (We) attest that we are in compliance with all applicable New York State Laws and are not the
subject of any state enforcement proceedings relating thereto. Yes
“I understand that the statements made in this application will be accepted for all purposes as the
equivalent of an Affidavit and that any false statements made herein, in addition to being the possible
basis for a revocation of any research approval given as a result of this application, may be punishable as
a misdemeanor under the provisions of Section 210.45 of the Penal Law of the State of New York.”
Signature Date
Printed name and title
Legal name of Business/Partnership/Corporation
To ensure that your application is not rejected as incomplete, make sure all the following information
in complete and all documentation is attached to your application:
All questions have been answered.
The application fee of $500 is included as a check or money order.
Contact industrialhempNYS@agriculture.ny.gov
if paying by credit card.
All additional sheets have been completed and are attached.
Maps and GPS coordinates of each growing site are attached.
Application has been signed and dated.
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Completed 14 July 2021

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