Form MJ15-1201 "Marijuana Security Waiver Request" - Oregon

What Is Form MJ15-1201?

This is a legal form that was released by the Oregon Liquor Control Commission - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2018;
  • The latest edition provided by the Oregon Liquor Control Commission;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MJ15-1201 by clicking the link below or browse more documents and templates provided by the Oregon Liquor Control Commission.

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Download Form MJ15-1201 "Marijuana Security Waiver Request" - Oregon

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OREGON LIQUOR CONTROL COMMISSION
Marijuana Security Waiver Request
What is this form?
OAR 845-025-1400(1)(a)
allows a recreational marijuana licensee to request that the Commission waive one or more of
the security requirements described in
OAR 845-025-1400 to 845-025-1470
by submitting a security plan for approval.
Applicants or Licensees may use this form to document the required information in order to make such a request.
What must be included?
The specific rule and subsections of a rule that is requested to be waived;
The reason for the waiver;
A description of the intended alternative safeguard and how it accomplishes the goals of the rules specifically
as relates to:
Public safety;
o
Preventing diversion of product;
o
Licensee accountability;
o
Preventing minors from gaining access to the premises and marijuana items.
o
Section 1 – Business Information
For new applicants, enter information for the business seeking to be licensed, as identified on the license application. For
licensees, enter information for the licensed business.
Business Name:
Trade Name:
Mailing Address:
City:
State:
ZIP:
 
Physical Address:
City:
State:
ZIP:
 
Primary Contact:
Main Phone:
Cell Phone:
Email:
[FORM MJ 15‐1201] mj_opt_all_security_waiver (12/28) Page 1 of 4 
 
 
OREGON LIQUOR CONTROL COMMISSION
Marijuana Security Waiver Request
What is this form?
OAR 845-025-1400(1)(a)
allows a recreational marijuana licensee to request that the Commission waive one or more of
the security requirements described in
OAR 845-025-1400 to 845-025-1470
by submitting a security plan for approval.
Applicants or Licensees may use this form to document the required information in order to make such a request.
What must be included?
The specific rule and subsections of a rule that is requested to be waived;
The reason for the waiver;
A description of the intended alternative safeguard and how it accomplishes the goals of the rules specifically
as relates to:
Public safety;
o
Preventing diversion of product;
o
Licensee accountability;
o
Preventing minors from gaining access to the premises and marijuana items.
o
Section 1 – Business Information
For new applicants, enter information for the business seeking to be licensed, as identified on the license application. For
licensees, enter information for the licensed business.
Business Name:
Trade Name:
Mailing Address:
City:
State:
ZIP:
 
Physical Address:
City:
State:
ZIP:
 
Primary Contact:
Main Phone:
Cell Phone:
Email:
[FORM MJ 15‐1201] mj_opt_all_security_waiver (12/28) Page 1 of 4 
 
 
OREGON LIQUOR CONTROL COMMISSION
Marijuana Security Waiver Request
Section 2 – Requirement to be Waived
Identify the specific requirement you are requesting to be waived. You will need to include the applicable section of rule
under
OAR 845-025-1400 to
845-025-1470, the full text of the rule, the reason you are requesting the waiver, and a
proposed alternative that meets the intent of the specific requirement stated in the rule.
To request waiver of additional security requirements, complete additional waiver request forms. A separate waiver
request is required for each security requirement you are asking the Commission to waive.
I am requesting a waiver of the requirements under this specific rule and subsection(s):
OAR 845-025-
Which states:
[FORM MJ 15‐1201] mj_opt_all_security_waiver (12/28) Page 2 of 4 
 
 
OREGON LIQUOR CONTROL COMMISSION
Marijuana Security Waiver Request
Section 3 – Reason for Request
I am requesting this waiver because:
If you are requesting the waiver because a state or local law prohibits the specific measure, identify the specific
law and how it prohibits your business from meeting this requirement. If an exception is allowed by permit,
document any attempts to obtain such a permit. Attach supporting documentation if needed.
If you are requesting a waiver because you believe compliance with a particular security provision is impossible
due to circumstances beyond your control or would be cost prohibitive, clearly document how that is the
case.Attach supporting documentation if needed.
[FORM MJ 15‐1201] mj_opt_all_security_waiver (12/28) Page 3 of 4 
 
OREGON LIQUOR CONTROL COMMISSION
Marijuana Security Waiver Request
Section 4 – Alternative Safeguards and Security Plan
Describe the proposed alternative safeguards and how they will accomplish the goals of the security rule as it relates to
public safety, preventing diversion of marijuana products to the illegal market, maintaining accountability by the licensee
and employees, and preventing minors from gaining access to the premises and marijuana.
[FORM MJ 15‐1201] mj_opt_all_security_waiver (12/28) Page 4 of 4 
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