Ariz. Admin. Code § R9-17-312 - Submitting an Application to Renew a Dispensary Agent's Registry Identification Card

To renew a dispensary agent's registry identification card, a dispensary shall submit to the Department, at least 30 calendar days before the expiration of the dispensary agent's registry identification card, the following:

1. An application in a Department-provided format that includes:

a. The dispensary agent's first name; middle initial, if applicable; last name; and suffix, if applicable;

b. The dispensary agent's residence address and Arizona mailing address;

c. The county where the dispensary agent resides;

d. The dispensary agent's date of birth;

e. The registry identification number on the dispensary agent's current registry identification card;

f. The name and registry identification number of the dispensary; and

g. The signature of the individual in R9-17-304(C)(1)(d) or of a principal officer or board member, as applicable, designated to submit dispensary agent applications on the dispensary's behalf and the date signed;

2. An attestation signed and dated by the dispensary agent that the dispensary agent:

a. Has not been convicted of an excluded felony offense as defined in A.R.S. § 36-2801, or

b. Is deemed to not have been convicted of an excluded felony offence through holding a valid level I fingerprint clearance card issued according to A.R.S. § 41-1758.07;

3. If the dispensary agent's name in subsection (1)(a) is not the same name as on the dispensary agent's current registry identification card, one of the following with the dispensary agent's new name:

a. An Arizona driver's license,

b. An Arizona identification card, or

c. The photograph page in the dispensary agent's U.S. passport or a U.S. passport card;

4. A statement in a Department-provided format signed by the dispensary agent pledging not to divert marijuana to any individual who or entity that is not allowed to possess marijuana pursuant to A.R.S. Title 36, Chapter 28.1;

5. A current photograph of the dispensary agent;

6. For the Department's criminal records check authorized in A.R.S. § 36-2804.05:

a. The dispensary agent's fingerprints on a fingerprint card that includes:

i. The dispensary agent's first name; middle initial, if applicable; and last name;

ii. The dispensary agent's signature;

iii. If different from the dispensary agent, the signature of the individual physically rolling the dispensary agent's fingerprints;

iv. The dispensary agent's address;

v. If applicable, the dispensary agent's surname before marriage and any names previously used by the dispensary agent;

vi. The dispensary agent's date of birth;

vii. The dispensary agent's Social Security number;

viii. The dispensary agent's citizenship status;

ix. The dispensary agent's gender;

x. The dispensary agent's race;

xi. The dispensary agent's height;

xii. The dispensary agent's weight;

xiii. The dispensary agent's hair color;

xiv. The dispensary agent's eye color; and

xv. The dispensary agent's place of birth;

b. If the dispensary agent's fingerprints and information required in subsection (6)(a) were submitted to the Department as part of an application for a designated caregiver registry identification card, dispensary agent registry identification card for another dispensary, or laboratory agent registry identification card within the previous six months, the registry identification number on the registry identification card issued to the dispensary agent as a result of the application; or

c. Documentation that the dispensary agent has a valid level I fingerprint clearance card issued according to A.R.S. § 411758.07; and

7. The applicable fee in R9-17-102 for applying to renew a dispensary agent's registry identification card.

Notes

Ariz. Admin. Code § R9-17-312

New Section made by exempt rulemaking at 17 A.A.R. 734, effective April 14, 2011 (Supp. 11-2). Amended by emergency rulemaking at 18 A.A.R. 1010, effective April 11, 2012 for 180 days (Supp. 12-2). Emergency expired (Supp. 12-4). Amended by final rulemaking at 18 A.A.R. 3354, with an immediate effective date of December 5, 2012 (Supp. 12-4). Amended by exempt rulemaking at 27 A.A.R. 747, effective 5/3/2021. Amended by final expedited rulemaking at 28 A.A.R. 2562, effective 9/8/2022.