Current through Register Vol. 30, No. 38, September 20, 2024
To obtain a laboratory agent registry identification card for
an individual serving as an owner for the laboratory, employed by the
laboratory, or providing volunteer services at or on behalf of the laboratory,
the owner shall submit to the Department the following for each laboratory
agent:
1. An application in a
Department-provided format that includes:
a.
The laboratory agent's first name; middle initial, if applicable; last name;
and suffix, if applicable;
b. The
laboratory agent's residence address and Arizona mailing address;
c. The county where the laboratory agent
resides;
d. The laboratory agent's
date of birth;
e. The identifying
number on the applicable card or document in subsection (4)(a) through
(e);
f. The name and registry
identification number of the laboratory; and
g. The signature of the individual in
R9-17-402(A)(1)(c) designated to submit laboratory agent applications on the
laboratory's behalf and the date the individual signed;
2. An attestation signed and dated by the
laboratory agent that the laboratory agent:
a. Either:
i. Has not been convicted of an excluded
felony offense as defined in A.R.S. §
36-2801, or
ii. Is deemed to not have been convicted of
an excluded felony offense through holding a valid level I fingerprint
clearance card issued according to A.R.S. §
41-1758.07; and
b. Will not test medical marijuana
and medical marijuana products for:
i. A
dispensary, related medical marijuana business entity, or management company
that the laboratory agent has a direct or indirect familial or financial
relationship with or interest in; or
ii. A designated caregiver who the laboratory
has a direct or indirect familial or financial relationship with;
3. A statement in a
Department-provided format, signed by the laboratory agent, pledging not to
divert marijuana to any individual who or entity that is not allowed to possess
marijuana pursuant to A.R.S. Title 36, Chapter 28.1;
4. A copy of the
laboratory agent's:
a. Arizona driver's
license issued on or after October 1, 1996;
b. Arizona identification card issued on or
after October 1, 1996;
c. Arizona
registry identification card;
d.
Photograph page in the laboratory agent's U.S. passport or a U.S. passport
card; or
e. Arizona driver's
license or identification card issued before October 1, 1996 and one of the
following for the laboratory agent:
i. Birth
certificate verifying U.S. citizenship,
ii. U.S. Certificate of Naturalization,
or
iii. U.S. Certificate of
Citizenship;
5. A current photograph
of the laboratory agent;
6. For the Department's
criminal records check authorized in A.R.S. §§
36-2804.01 and
36-2804.07:
a. The laboratory agent's fingerprints on a
fingerprint card that includes:
i. The
laboratory agent's first name; middle initial, if applicable; and last
name;
ii. The laboratory agent's
signature;
iii. If different from
the laboratory agent, the signature of the individual physically rolling the
laboratory agent's fingerprints;
iv. The laboratory agent's address;
v. If applicable, the laboratory agent's
surname before marriage and any names previously used by the laboratory
agent;
vi. The laboratory agent's
date of birth;
vii. The laboratory
agent's Social Security number;
viii. The laboratory agent's citizenship
status;
ix. The laboratory agent's
gender;
x. The laboratory agent's
race;
xi. The laboratory agent's
height;
xii. The laboratory agent's
weight;
xiii. The laboratory
agent's hair color;
xiv. The
laboratory agent's eye color; and
xv. The laboratory agent's place of
birth;
b. If the
laboratory agent's fingerprints and information required in subsection (6)(a)
were submitted to the Department within the previous six months as part of an
application for a designated caregiver registry identification card, a
dispensary agent registry identification card, or a laboratory agent registry
identification card, the registry identification number on the registry
identification card issued to the laboratory agent as a result of the
application; or
c. Documentation
that the laboratory agent has a valid level I fingerprint clearance card issued
according to A.R.S. §
41-1758.07;
and
7. The applicable fee in
R9-17-102 for applying for a laboratory agent registry identification
card.