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Office of Cannabis Management Enforcement Complaint Reporting Form

Instructions: You may use this form to file a business complaint or report a violation related to residential concerns, home grow, personal possession, testing, or license holders.

Local governments should utilize this form to share information, concerns, or complaints about cannabis businesses under the local government expedited complaint process (Minnesota Statutes section 342.13).

The information you provide will be evaluated to determine a course of action or investigation.

Survey Timestamp

D-M-Y H:M:S

Your First Name

* must provide value

Last Name

* must provide value

Mailing Address

* must provide value

City

* must provide value

State

* must provide value

ZIP Code

* must provide value

Email Address

* must provide value

Phone number

* must provide value

Name of Company or Site of Complaint

* must provide value

Date and Time of Incident

* must provide value

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Address of business or residence you are filing a complaint against

* must provide value

City

* must provide value

State

* must provide value

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ZIP Code

* must provide value

Phone Number of business or residence, if known

How do you want to be notified about this complaint?

* must provide value

Notify me at the email listed above. By checking this box, you are waiving your right to confidentiality for the limited purposes of exchanging such data with OCM your personal, unsecured, email address.

Notify me by U.S. mail.

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Type of Complaint (select all that apply)

* must provide value

Noncompliant Product

Labeling

Signage/Marketing/Advertising

Product Placement

Testing/Lab

Underage Sales

Unlicensed Business

On-Site Consumption

Event

Residential Issue

Other

Do you currently reside in a residential multifamily dwelling (apartment, townhome, duplex etc.)?

* must provide value

Yes

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Is the residence you're reporting owned by the individuals living there or rented?

* must provide value

Individuals living there

Rented

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What is the name of the landlord, property management company, or Homeowners association (HOA)?

* must provide value

What is the mailing address for that landlord, property management company, or HOA?

* must provide value

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Have you already contacted the landlord, property manager, or HOA about this problem?

* must provide value

Yes

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If yes, what did they say or do?

* must provide value

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If you checked "Other," please describe.

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Is this complaint officially on behalf of law enforcement or for any city, county, or state government?

* must provide value

Yes

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If yes, please tell us the department name or municipality the report was filed (also include Police Report Number, if available).

Is this complaint directly related to a website (that is, your complaint relates to content or products from a website or you purchased product for delivery to you from the internet)?

* must provide value

Yes

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If yes, please enter the website address.

Did you or another individual experience physical harm or adverse effects (describe further in your statement of complaint)?

* must provide value

Yes

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If yes, was medical attention obtained or required (for example, emergency room visit, hospitalization).

Yes

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Have you also filed a police report regarding this complaint or any aspects of this matter?

* must provide value

Yes

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If yes, tell us the department name or municipality the report was filed (include Police Report Number if available).

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You may attach or send additional photos/documents as necessary to support the complaint.
PLEASE DO NOT SEND ANY PHYSICAL PRODUCTS TO THE OFFICE OF CANNABIS MANAGEMENT.

Upload file

Please describe your complaint. The information you provide may be used in the efforts to resolve the problem, to communicate with you or the subject of the complaint, and/or to enforce applicable laws. The information may be shared with the party complained against, law enforcement agencies and consumer assistance agencies. You are not legally required to provide this information, but failure to do so may hinder efforts to resolve your problem (Limit to 500 characters).

Please review all instructions carefully prior to submitting the complaint form. If the form is not complete, you will be asked to resubmit. You must complete the complainant registration and sign the document as you would sign a legal document.

This information which I am not legally required to submit, is offered so that the Office of Cannabis Management may evaluate and investigate this complaint, and if necessary, submit this information in any legal proceeding. The Office of Cannabis Management may be required to release this information as a part of legal proceedings or pursuant to the Minnesota Government Data Practices Act. The Office of Cannabis Management may share this information with the Office of the Attorney General, which may help the Office of Cannabis Management investigate the complaint, and which serves as the Office of Cannabis Management's legal counsel.

* must provide value

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Signature

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Add signature

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M-D-Y

Saved on Network

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Yes

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Date Sent to OCM Staff

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D-M-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.