Questions? Please contact us at:

reporting.mmcc@maryland.gov

849 International Drive, 4th Floor, Linthicum, MD, 21090, US

CHANGE OF LOCATION APPLICATION

Legal Name *

MMCC License/Registration # *

Trade Name (If none enter N/A) *

Are you a Licensee or Registrant?

IMPORTANT: A licensee may request to change the location of the licensee's operation by submitting this request form to the Commission, along with the change of location fee ($7,000) . COMAR 10.62.35.01 (A)(10)(b) Licencees may not begin cultivating, dispensing, or processing medical cannabis at a new location until they have passed all inspections. COMAR 10.62.08.09, 10.62.19.08, 10.62.25.09

Dispensary

Grower

Processor

Independent Testing Laboratory

Security Guard Agency

Secure Transport Company

Waste Disposal Company

Business Contact Information

CURRENT Contact Information

Email *

Telephone *

Fax *

CURRENT Physical Address

Address or Location

Senatorial District of current address

NEW Contact Information

Email *

Telephone *

Fax *

NEW Proposed Physical Address

Address or Location

Senatorial District of proposed address

Written formal request outlining the: (1) change of location request, (2) projected timeline of change of location, if approved, (3) non-opposition or support from local government where new proposed facility is located, and (4) business necessity to support change of location request (e.g., zoning, community opposition, damage or destruction to facility, or significant economic factors).

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IS YOUR PHYSICAL ADDRESS THE SAME AS YOUR MAILING ADDRESS?

Yes - our Physical Address is also our Mailing Address

No - our Mailing Address is different

Fee Payment Confirmation

Date Paid *

Cashier's Check # or Money Order # *

The below authorized representative of the licensee or registrant acknowledges and affirms that the (1) information included in this application is accurate and complete, and (2) licensee or registrant may only operate at one licensed or registered premises.

Enter your email address here if you would like a copy of this submission.

First Name

Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.