Marijuana Business Individual History Form Form Instructions What is this form? Use this form to provide personal history information for each individual who qualifies as an applicant for a marijuana.
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How to use or fill out the OR OLCC MJ 17-1010 online
The OR OLCC MJ 17-1010 form is essential for individuals applying for a marijuana license in Oregon. This guide provides user-friendly, step-by-step instructions to ensure you complete the form accurately and efficiently.
Follow the steps to fill out the OR OLCC MJ 17-1010 online carefully.
- Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
- Begin with Section 1 – Individual History Statement. Fill in your first name, middle initial, and last name accurately.
- Enter your date of birth by selecting the month, day, and year from the provided options.
- Specify your gender by selecting one of the options: Male, Non-Binary, Female, or Opt-Out.
- Provide your mailing address, including city, state, and ZIP code.
- Enter your contact phone number and email to ensure effective communication.
- If applicable, enter your social security number. This field is mandatory unless you do not have one.
- Indicate your consent for using your social security number for identity verification purposes during the criminal records check.
- Answer whether you have ever been convicted of a felony. If yes, attach an explanation.
- Report any unresolved arrests or citations for misdemeanor or felony charges.
- List all business names and license numbers for any OLCC liquor or marijuana licenses you have previously applied for or hold.
- Proceed to Section 2 – Acknowledgement. Sign and date the form to confirm that your answers are accurate.
- Once completed, save your changes, and download, print, or share the form as needed.
Complete your OR OLCC MJ 17-1010 form online today for a smoother application process.
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