Hemp Acquisition Form

A licensed processor must submit this form to the MCA, after placing an order to acquire hemp and before accepting delivery of the hemp. COMAR 14.17.11.03(B)(2)

Licensee Information

License Name

Legal Name

Trade Name (D/B/A) (Put N/A if Not Applicable)

MCA License #

Contact Email Address (confirmation email sent to this address)

Hemp Producer Information

Name of Hemp Producer *

State where Hemp Producer is Located *

Please upload an invoice showing that the licensee purchased the hemp from the hemp producer identified above.

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Please upload a copy of the hemp producer's license to produce hemp. (NOTE: The license must be issued by the USDA, the Maryland Department of Agriculture, or an agency of another state that administers a hemp production program that has been approved by the USDA)

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First Name

Last Name

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I hereby confirm the following: I am a representative of the named Licensee and I am authorized to submit this Hemp Acquisition Form to the Maryland Cannabis Administration. The information provided in this form has been verified.