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. Any incomplete information may result in an application being delayed or denied. If using pen, use BLUE or BLACK ink only and print clearly.
I understand that by signing this authorization, a financial record check of my tax filing and tax obligation status will be performed. I authorize my respective state taxing agency to surrender to the Bureau a complete and accurate record of any and all tax information
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