Transcription of ENTITY/INDIVIDUAL PREQUALIFICATION ... - …
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ENTITY/INDIVIDUAL PREQUALIFICATION ... - …
Agency Use Only_____ Application ID BMMR (New Dec-17) Page 1 of 21 Bureau of Medical Marihuana Regulation Box 30205 Lansing, MI 48909 Telephone: (517) 284-8599 ENTITY/INDIVIDUAL PREQUALIFICATION APPLICATION PACKET This ENTITY/INDIVIDUAL PREQUALIFICATION application packet and the supplemental applicant PREQUALIFICATION packet and requested supporting documentation is the FIRST of two steps in the application process for consideration for a marihuana facility license. Please refer to the Application Instruction Booklet for instructions on how to complete all forms in the applications process and the manner in which your forms and documents must be arranged and submitted at: All questions on this form must be answered completely and truthfully.
BMMR (New Dec-17) Page 3 of 21 . ATTESTATION A (Use BLUE or BLACK ink ONLY) APPLICANT’S ACKNOWLEDGEMENT, AGREEMENT, AND CONSENT (To be completed and signed by entity/individual seeking licensure)
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