The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

zJYNwXWoaz4Z2sTeIiiaA8FWT3oLvXhzBqK76CXEv4APwvZXFgp7mRqvUXkKaqboA7GVwPcFyqS2UGqDYAMi83XhcRtFqMffAGLdb6PWm3d

Hemp Derived Cannabinoid Products Business Registration Form

Minnesota requires sellers of hemp derived cannabinoid products (including exclusive liquor stores) to register with the State of Minnesota. Retailers and manufacturers (including those that sell directly to consumers, such as breweries that make hemp-THC beverages) must register. Out-of-state manufacturers that sell online or to businesses in Minnesota must also register.

By completing this form, your business will be registered with the Office of Cannabis Management as a Hemp Derived Cannabinoid Product business, a.k.a., an edible cannabinoid business. This is not a license. Licensing will be available at a later date through the Office of Cannabis Management and will be communicated to the business owner as identified on this form.

In addition, your establishment may be inspected by the Office of Cannabis Management to ensure the establishment is in compliance with all applicable laws and regulations.

Please complete the registration below.

***If you have more than one location please register each one separately****

Thank you

*Business Name (legal entity including DBA if applicable)
*Business Physical Address (No PO Boxes)
*City
*State (ex. MN)
*ZIP Code
*County

Business Phone

* must provide value

Business Website Address

Confirm Business Website Address

URL's do not match yet.

Business Owner Contact Information

* must provide value

Business Owner's Phone

* must provide value

Is the Business mailing address the same as the Business Physical Address?

* must provide value

Yes

reset

*Business Mailing Address
*City
*State (ex. MN)
*ZIP Code
*County

*required

Business Owner's Email (OCM will use this email address to communicate with your business).

* must provide value

Confirm Business Owner's Email

* must provide value

Emails do not match yet

Type of Business

* must provide value

Convenience Store

Bar

Restaurant

Exclusive Liquor Store

Hemp/Edible Cannabinoid Store

Hair or Nail Salon/Barbershop

Grocery Store

Smoke Shop

Brewery/Distillery

Manufacturer/Wholesaler

Other

reset

Describe Type

Current Hours of Operation

Day	Open?	Opening Time	AM\PM	Closing Time	AM\PM
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Current Hemp Derived Cannabinoid Products Offered for Sale (select all that apply)

* must provide value

Edible Cannabinoids (food)

Beverages

Topicals

Other

Describe Other Products

Is the business registered with the Minnesota Department of Revenue and have added the Cannabis Tax to its profile?

* must provide value

Yes

reset

I, the undersigned, attest that I am an authorized representative with signature authority for the business listed above and that the business is in compliance with all requirements described in MN Statute 151.72 and all other applicable state and local laws and ordinances. I further attest that the business will stay in compliance with MN Statute 151.72 and all other applicable state and local laws and ordinances.

* must provide value

Yes

reset

Full Name of the person completing the form

* must provide value

Email of the person completing the form

* must provide value

Confirm Email Address

* must provide value

Emails do not match yet

Comments

Expand

Date

M-D-Y

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.