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Get Me Form 110101 2018-2025
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How to fill out the ME Form 110101 online
Filling out the ME Form 110101 is an essential step for individuals seeking caregiver designation under the Maine medical use of marijuana program. This guide provides a clear and supportive walkthrough to ensure you complete the form accurately and efficiently.
Follow the steps to complete the ME Form 110101 online.
- Click ‘Get Form’ button to access the ME Form 110101 and open it in the online editor.
- Begin by filling out Section 1, which includes primary caregiver information. Indicate whether you are a new applicant, renewing an existing application, or adding a patient. Provide your legal name, date of birth (must be at least 21), telephone number, home address, city, state, zip, email address, and either your Social Security Number or Federal Identification Number.
- In Section 2, specify any applicable fees. If applicable, provide the name of the nursing facility or hospice and enter the number of patients you will be cultivating for (maximum of 5). Calculate the total cultivation fee based on $240 multiplied by the number of patients. Ensure to include the caregiver criminal background check fee of $31, which is mandatory annually. Note that all fees are non-refundable.
- Fill out Section 3 regarding cultivation location. Provide the street address, city, state, zip, and county. Indicate whether the location is indoors or outdoors and describe both in the provided fields. If you do not own the property, provide the legal name and address of the property owner.
- In Section 4, compile the necessary documents for submission. Ensure you have included a bank check or money order made payable to 'Treasurer, State of Maine' and a copy of your current Maine driver's license or another Maine-issued photographic identification card.
- Complete Section 5, where you acknowledge and agree to the responsibilities and legal obligations as a caregiver. Sign and date the form in the designated fields to confirm that the information you have provided is true and correct.
- Once all sections are complete and reviewed, save changes. You can then download, print, or share the form as needed before submitting it along with the required fees to the specified address.
Begin filling out the ME Form 110101 online today to ensure your application is processed smoothly.
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