A. To apply for an initial marijuana
establishment license, an applicant shall electronically submit to the
Department, during the application period specified according to
R9-18-302(A)(1) :
1. The following information
in a Department-provided format:
a. The legal
name of the proposed marijuana establishment;
b. The physical address of the proposed
marijuana establishment's retail site;
c. The county in which the proposed marijuana
establishment's retail site is located;
d. The following information for the
applicant:
i. Name of the entity
applying,
ii. Type of business
organization,
iii. Arizona mailing
address,
iv. Telephone number,
and
v. E-mail address;
e. The name, residence address,
and date of birth of each principal officer and each board member, according to
R9-18-301;
f. The name, residence
address, and, if applicable, date of birth of any person who is entitled to 10%
or more of the profits of the proposed marijuana establishment;
g. Whether the applicant agrees to allow the
Department to submit supplemental requests for information;
h. An attestation that, if the applicant is
issued a marijuana establishment license, the proposed marijuana establishment
will not operate until the proposed marijuana establishment is inspected and
obtains an approval to operate from the Department;
i. An attestation that the applicant
understands and will comply with the requirements in A.R.S. Title 36, Chapter
28.2, and this Chapter;
j. An
attestation that information provided to the Department to apply for a
marijuana establishment license is true and correct; and
k. The signatures of each principal officer
and each board member of the proposed marijuana establishment according to
R9-18-301 and the date signed;
2. Documentation that the applicant is in
good standing with the Arizona Corporation Commission;
3. For each principal officer and each board
member listed according to subsection (A)(1)(e), documentation of the principal
officer's or board member's marijuana facility agent license;
4. An attestation, in a Department-provided
format, from each principal officer and each board member listed according to
subsection (A)(1)(e) that the principal officer or board member:
a. Does not have an excluded felony offense,
as defined in A.R.S. §
36-2801;
b. Does not have a direct or indirect
familial or financial relationship with a marijuana testing facility;
and
c. Has not had an ownership
interest in a licensed marijuana business that had the license revoked in
another state;
5. The
application fee in
R9-18-102 for a marijuana
establishment license.
