Form MJ20-1060 "Marijuana Applicant Questionnaire" - Oregon

What Is Form MJ20-1060?

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 October 15, 2020;
  • 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 MJ20-1060 by clicking the link below or browse more documents and templates provided by the Oregon Liquor Control Commission.

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Download Form MJ20-1060 "Marijuana Applicant Questionnaire" - Oregon

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Marijuana Applicant Questionnaire
Form Instructions
What is this form?
Use this form to provide OLCC with a complete list of individuals and legal entities (e.g. LLC, corporation, limited
partnership, limited liability partnership, trust, sole proprietor) who are applicants for your marijuana license. As part of our
efforts to streamline the licensing process, OLCC is no longer routinely collecting detailed business structure information
prior to issuing the license.
Failure to completely and accurately disclose every individual and legal entity who is an applicant for this license may
constitute grounds to deny or revoke a license.
How do I know who is an applicant for the license?
It is your responsibility to read and understand the rules and correctly identify each individual and entity who qualifies as
an “applicant” as described in OAR 845-025-1045. OLCC has provided
Guidance on Disclosing Interests in a
Recreational Marijuana Business
to help businesses understand the rules and their obligations under the rules.
As described in OAR 845-025-1045, “applicant” includes any individual or legal entity who holds or controls a direct or
indirect interest of 20% or more in a recreational marijuana business, as well as any individual or entity who has an
“ownership Interest” in the business (see below). Both categories are considered the applicant(s) for a license, and will be
considered licensee(s) once a license is issued.
This includes any individual or legal entity entitled to receive 20% or more in revenue or profits from the business, whether
or not they are part of the proposed business itself. For example, a landlord receiving 20% or more in profits as part of a
rental agreement is considered an applicant.
“Ownership interest” is defined in OAR
845-025-1045
and includes:
Exercising control over, or having the right to exercise control over, the business. This includes having the right to
control access to the premises.
Incurring debt, entering into contracts, or entering into other similar obligations on behalf of the business.
Being named as a lessee of the proposed premises. If there is no lease, then the property owner is considered to
be an applicant for the license.
If an applicant is a legal entity, any individual or other legal entity who meets any of the following criteria is also
considered an applicant:
Managers of a manager-managed LLC
Principal officers of a corporation
General partners of a limited partnership
When legal entities own interests in other legal entities at multiple layers, those “nested” legal entities may also be
considered applicants depending on the percentage of ownership and role in the business. For example, an entity that
holds 50% ownership of a holding company that in turn holds 50% ownership in the business is considered to hold an
indirect ownership interest of 25% and would be an applicant for the license.
What other information may be required?
Each individual who is listed as an applicant must complete and sign an
Individual History form
that must be submitted as
part of the application.
OLCC may ask you to disclose your complete business structure in the future, but that information should not be listed on
this form.
Marijuana Applicant Questionnaire Instructions
Revised 20201015
Marijuana Applicant Questionnaire
Form Instructions
What is this form?
Use this form to provide OLCC with a complete list of individuals and legal entities (e.g. LLC, corporation, limited
partnership, limited liability partnership, trust, sole proprietor) who are applicants for your marijuana license. As part of our
efforts to streamline the licensing process, OLCC is no longer routinely collecting detailed business structure information
prior to issuing the license.
Failure to completely and accurately disclose every individual and legal entity who is an applicant for this license may
constitute grounds to deny or revoke a license.
How do I know who is an applicant for the license?
It is your responsibility to read and understand the rules and correctly identify each individual and entity who qualifies as
an “applicant” as described in OAR 845-025-1045. OLCC has provided
Guidance on Disclosing Interests in a
Recreational Marijuana Business
to help businesses understand the rules and their obligations under the rules.
As described in OAR 845-025-1045, “applicant” includes any individual or legal entity who holds or controls a direct or
indirect interest of 20% or more in a recreational marijuana business, as well as any individual or entity who has an
“ownership Interest” in the business (see below). Both categories are considered the applicant(s) for a license, and will be
considered licensee(s) once a license is issued.
This includes any individual or legal entity entitled to receive 20% or more in revenue or profits from the business, whether
or not they are part of the proposed business itself. For example, a landlord receiving 20% or more in profits as part of a
rental agreement is considered an applicant.
“Ownership interest” is defined in OAR
845-025-1045
and includes:
Exercising control over, or having the right to exercise control over, the business. This includes having the right to
control access to the premises.
Incurring debt, entering into contracts, or entering into other similar obligations on behalf of the business.
Being named as a lessee of the proposed premises. If there is no lease, then the property owner is considered to
be an applicant for the license.
If an applicant is a legal entity, any individual or other legal entity who meets any of the following criteria is also
considered an applicant:
Managers of a manager-managed LLC
Principal officers of a corporation
General partners of a limited partnership
When legal entities own interests in other legal entities at multiple layers, those “nested” legal entities may also be
considered applicants depending on the percentage of ownership and role in the business. For example, an entity that
holds 50% ownership of a holding company that in turn holds 50% ownership in the business is considered to hold an
indirect ownership interest of 25% and would be an applicant for the license.
What other information may be required?
Each individual who is listed as an applicant must complete and sign an
Individual History form
that must be submitted as
part of the application.
OLCC may ask you to disclose your complete business structure in the future, but that information should not be listed on
this form.
Marijuana Applicant Questionnaire Instructions
Revised 20201015
OREGON LIQUOR CONTROL COMMISSION
Marijuana Applicant Questionnaire
Section 1 – Business Information
Licensee Name:
Premises Address:
City:
State:
OR
ZIP:
Section 2 – Applicants
List every individual and legal entity who meets the qualifications of an “applicant” for this license, as
described in OAR 845-025-1045:
1.
11.
2.
12.
3.
13.
4.
14.
5.
15.
6.
16.
7.
17.
8.
18.
9.
19.
10.
20.
If there are more than 20 applicants, attach additional pages as needed
.
Section 3 – Acknowledgement
I affirm that, in Section 2, I have listed every natural person and legal entity who meets the qualifications
of an “applicant” for this business, as described in OAR 845-025-1045.
I understand that if my answers are not true and correct that the OLCC may deny my application.
Signature:
Date:
Name:
Title:
[FORM MJ 20-1060] mj_app_applicants (20201015) Page 1 of 1
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