Cannabis Intake Form Intake form for Cannabis Risk Section 1: Account InformationLegal Business Name(Required) DBA Mailing Address(Required) Street Address Unit Number City State / Province / Region ZIP / Postal Code Enterprise Type(Required) Corporation Partnership LLC Individual Other Operations (Check ALL)(Required) Cultivation Processor Wholesale/Distribution Manufacturer/Extraction Transportation Delivery Operations Retail - Cannabis Retail - CBD Other Years in Business New Venture 1-3 years 4-10 years Over 10 years If new venture, do any of the owners have a minimum of 1 year experience in the cannabis, CBD, or Hemp Industry? YES NO Is the applicant a member of any cannabis, CBD, or hemp trade associations? Yes No Number of Employees Total Payroll in $ - Annual Gross Sales - Annual Consent I agree to the privacy policy.
