For background purposes, use full legal name. This name will also be printed
on applicant’s permit.
Physical address of any buildings that are owned/leased by the company and used in any part of the processing operation.
For official correspondence with our office.
Each owner of more than a 10% interest in the processing operations, as well as employees.
Under the penalties imposed by K.S.A. 21-3805, I declare that I have examined this application and any documents submitted in support thereof, and to the best of my knowledge and belief, they are true, correct and complete. I also certify that I am familiar with all published state laws and local ordinances relating to hemp processing for the location(s) in which I intend to do business.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Only PDFs are accepted
Additional officers, proprietors, partners of entity and/or employees.
Policies and Procedures Manual
Fingerprint cards, signed Consent to Search forms and criminal background checks for
applicant, additional officers, proprietors, partners of entity and/or employees
Supporting documents can be submitted to firstname.lastname@example.org after application is filed.
This field is not part of the form submission.
* indicates a required field