Get Attestation Form

Completing the Attestation Form is a vital step for individuals involved in the medical marijuana dispensary program. This guide will provide you with clear and supportive instructions on how to fill out the form online.

Follow the steps to complete the Attestation Form efficiently.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin by filling in your name on the first line, where it states 'I, ______________________, attest that:'. Ensure that you spell your name accurately to avoid any discrepancies.
3. In the next lines, check the first statement, confirming that you have not been convicted of an excluded felony offense as defined in A.R.S. § 36-2801. This is a critical requirement for eligibility.
4. Proceed to the next statement and affirm that you will not divert marijuana to any individual or organization not permitted to possess it under A.R.S. Title 26, Chapter 28.1. It is essential to understand the legal implications of this affirmation.
5. After completing these sections, you will need to provide your signature on the designated line, followed by the date you are signing the form.
6. If you are a Dispensary Principal Officer or Board Member, fill out the section that states 'I, ______________________, am designated to submit dispensary agent applications on the dispensary’s behalf.' Enter your name appropriately.
7. As with your personal section, provide your signature and the date on the lines provided.
8. Once you have filled out the entire form, you have the options to save your changes, download the completed form, print it for physical submission, or share it as needed.

Complete your documentation online to ensure compliance and facilitate the process.