mca.reporting@maryland.gov
849 International Drive 4th Floor, Suite 450
Please fill out the following form to request to transfer ownership interest in a cannabis business license. The following documents must be submitted along with this form:
Pre- and post-transfer capitalization tables;
For transfers of ownership interest that would result in 5% or greater ownership interest in the licensee, for each entity or individual that would hold direct or indirect ownership interest:
Full tax returns for the three most recent tax years in each jurisdiction filed, including all schedules and forms. Copies of tax returns filed in any state or country must be included;
If any tax returns indicate a balance owed, evidence from the taxing authority that the balance has been paid, or documentation that the taxpayer is current on a payment plan for that balance. COMAR 14.17.06.04D(1) requires that the MCA deny a request to transfer ownership interest if tax payments are in arrears in any jurisdiction for the proposed transferee;
Criminal History & Financial Attestations;
Ownership & Control Attestations;
Document that shows the effectuation of the transfer and the terms of that transfer (definitive documents). Please include any documentation, exhibits, or other attachments, including any ancillary documents that are referenced in the definitive documents, that may assist the MCA in reviewing your request. All documents must be executed.
Upon receipt, MCA staff will conduct an initial review to determine whether all required information has been provided and whether any additional information is necessary to evaluate the request. The request will not be reviewed by the Administration until all required information is submitted, and required fees paid. Failure to submit any of the required documents with your initial request will cause a delay in processing of your request.
Depending on the terms and complexity of the proposed transfer, the review and approval process may take 45 days or more.. All proposed transfers must comply with Alcoholic Beverages and Cannabis Article, §36-502 through 504.
A proposed transfer may not take effect until formal approval is received. Questions?
Please direct any questions to mca.reporting@maryland.gov
License Type (please select all applicable license types)
Name of Licensee
Name of Licensee 2 (if applicable)
Name of Licensee 3 (if applicable)
Name of Licensee 4 (if applicable)
Name of Licensee 5 (if applicable)
Name of Licensee 6 (if applicable)
Name of the Proposed Transferee
Full Name
Upload a complete capitalization table identifying the ownership structure of the licensee pre -transfer and post - transfer. MCA has created a template capitalization table that you may utilize to ensure you are providing complete ownership information, which can be found here: https://shorturl.at/xQdgJ . You may submit this information in a different form, but it must include all information required in order to be accepted.
Is the proposed transfer for an ownership interest of 5 percent or more?
Upload the three most recent tax returns filed by the transferee. If relevant, please also upload evidence of tax balances paid or documentation of a payment plan, as indicated at the top of this page.
Upload File(s)
Upload Definitive Documents
The Administration must receive the criminal history record information for any proposed transfer of 5% or more of the license or the entity holding the license. If the transferee is an entity, the criminal history record information must be submitted for any individual holding 5% or more of the transferee entity. This applies to publicly traded and privately held entities.
“Criminal history record information” consists of the results of a fingerprint check through Maryland Criminal Justice Information Services (CJIS) and the results of a fingerprint check through the Federal Bureau of Investigation (FBI). An individual who is required to provide criminal record history information may report to any CJIS location in Maryland for fingerprinting and request that a copy of the results be sent to the Administration by including the following information on the Livescan Application:
ORI # MD920525Z
Agency Authorization # 2100001956
A list of CJIS locations in Maryland is available here: https://www.dpscs.state.md.us/publicservs/fingerprint.shtml If an individual lives outside of Maryland and is unable to report to a CJIS location in Maryland for fingerprinting, instructions for submission of fingerprints for out of state residents can be found on the DPSCS website: https://www.dpscs.state.md.us/publicservs/bgchecks.shtml. The ORI and Agency Authorization numbers above should also be utilized for out-of-state fingerprinting.
Upload the "Ownership & Control Attestations of Prospective Transferee".
Click here to print the "Ownership & Control Attestations of Prospective Transferee".
Note: Required for proposed transfers of 5 percent or more in a license or the entity who holds a license. All completed attestation forms must be combined into a single PDF and uploaded above.
Upload the "Criminal History & Financial Attestations by Prospective Transferee".
Click here to print the "Criminal History & Financial Attestations by Prospective Transferee".
I have submitted copies of my federal and state returns for all required tax years to MCA. Any electronically filed returns may not have signatures but I attest that I have submitted all filed tax returns for each of those years without omission. All submitted tax returns are identical in content to the returns filed with the IRS and the governmental tax agency for each state.
I attest that the information reported on this form is accurate and complete as of this date: (Click on the box to select a date from the calendar)
Sign Here
