Application

For online application submission with electronic fee payment

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Please have all required documents scanned or saved ready for upload; including, but not limited to

  • Copy of final transaction documents for owner change application
  • List of additional 3PLPs to be used for physical distribution- include name of 3PLP and physical address from which product is distributed
  • Copy of home state license (out-of-state applicants)
  • Officers & Directors list
  • List of other states where licensure is held
  • Designated Responsible Party (DRP) Qualification Review Form
  • Disciplinary action documents (when applicable)

 

Paper Application Forms

Application Instructions and Checklist

Application Form

Designated Responsible Party Qualification Review Form

DRP Determination Worksheet

Board Authorization for Criminal History Records Check

Criminal History Records (background) Check Checklist

Criminal History Records Check- State Police Authorization Form

Criminal History Records Check- State Police Disclosure Form

Self-Inspection Guidelines / Check-List

Policy & Procedure Guidelines