Ariz. Admin. Code § R9-17-304 - Applying for a Dispensary Registration Certificate
1. More than one dispensary
registration certificate application for a location in a single geographic
area, or
2. more than five
dispensary registration certificate applications.
g. For each principal officer or
board member, whether the principal officer or board member:
i. Has served as a principal
officer or board member for a dispensary that had the dispensary registration
certificate revoked;
ii. Is a physician currently
providing written certifications for qualifying patients;
iii. Is a law enforcement officer;
or
iv. Is employed by or a contractor
of the Department;
a. The name of the business
organization,
b. The type of business
organization, and
c. The names and titles of the
individuals in R9-17-301(A) and (B) ;
b. For the Department's criminal
records check authorized in A.R.S. §§ 36-2804 and 36-2804.05
:
i. The principal officer's or
board member's fingerprints on a fingerprint card that
includes:
(1) The principal officer's or
board member's first name; middle initial, if applicable; and last
name;
(2) The principal officer's or
board member's signature;
(3) If different from the
principal officer or board member, the signature of the individual physically
rolling the principal officer's or board member's fingerprints;
(4) The principal officer's or
board member's residence address;
(5) If applicable, the principal
officer's or board member's surname before marriage and any names previously
used by the principal officer or board member;
(6) The principal officer's or
board member's date of birth;
(7) The principal officer's or
board member's Social Security number;
(8) The principal officer's or
board member's citizenship status;
(9) The principal officer's or
board member's gender;
(10) The principal officer's or
board member's race;
(11) The principal officer's or
board member's height;
(12) The principal officer's or
board member's weight;
(13) The principal officer's or
board member's hair color;
(14) The principal officer's or
board member's eye color; and
(15) The principal officer's or
board member's place of birth; or
ii. If the fingerprints and
information required in subsection (C)(3)(b)(i) were submitted to the
Department as part of an application for a designated caregiver registry
identification card, dispensary agent registry identification card, or
laboratory agent registry identification card within the previous six months,
the registry identification number on the registry identification card issued
to the principal officer or board member as a result of the
application;
b. Laboratory testing of medical
marijuana and medical marijuana products,
e. Patient education and
support;
6. Documentation from the local
jurisdiction where the proposed dispensary's physical address is located
that:
a. There are no local zoning
restrictions for the proposed dispensary's location, or
b. The proposed dispensary's
location is in compliance with any local zoning restrictions;
8. The proposed dispensary's
by-laws including:
a. The names and titles of
individuals designated as principal officers and board members of the proposed
dispensary;
b. Whether the proposed dispensary
plans to:
i. Cultivate
marijuana;
ii. Acquire marijuana from
qualifying patients, designated caregivers, or other
dispensaries;
iii. Sell or provide marijuana to
other dispensaries;
iv. Transport
marijuana;
v. Prepare, sell, or dispense
marijuana-infused edible food products;
vi. Prepare, sell, or dispense
marijuana-infused non-edible products;
vii. Sell or provide marijuana
paraphernalia or other supplies related to the administration of marijuana to
qualifying patients and designated caregivers;
viii. Deliver medical marijuana to
qualifying patients; or
ix. Provide patient support and
related services to qualifying patients;
c. Provisions for the disposition
of revenues and receipts to ensure that the proposed dispensary operates on a
not-for-profit basis; and
d. Provisions for amending the
proposed dispensary's by-laws;
9. A business plan demonstrating
the on-going viability of the proposed dispensary on a not-for-profit basis
that includes:
a. A description and total dollar
amount of expenditures already incurred to establish the proposed dispensary or
to secure a dispensary registration certificate by the applicant for the
dispensary registration certificate;
b. A description and total dollar
amount of monies or tangible assets received for operating the proposed
dispensary from entities other than the applicant for the dispensary
registration certificate or a principal officer or board member associated with
the applicant, including the entity's name and the interest in the dispensary
or the benefit the entity obtained;
c. Projected expenditures expected
before the proposed dispensary is operational;
d. Projected expenditures after
the dispensary is operational; and
e. Projected revenue;
and
Notes
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