Information and Procedure Bulletins
Public Convenience or Necessity Forms and Documents
Pre-Application Review Forms and Documents
Temporary Approval Forms and Documents
Renewal Forms and Documents
Social Equity Program Forms and Documents
Application Modification Forms and Documents
Application Supplements and Worksheets
All Application Forms (In Numerical Order)
These forms and documents are intended for use in DCR's Licensing Portal (Accela). Please do not submit official documents via email unless requested by an analyst. DCR may accept electronic signatures on forms, unless the form specifically requires a notarized signature.
Notice to Department of Cannabis Regulation Industry Professionals
If you are compensated to interact with the Department of Cannabis Regulation, City law may require you to register as a lobbyist and report your activity. Any individual may qualify as a lobbyist, regardless of occupation, education, training, or professional title. A lobbyist may hold a position that includes but is not limited to attorney, CEO, consultant, government liaison, business owner, permit applicant, engineer, scientist, grower, processor, cultivator, dispensary employee, marketer, packaging servicer and deliverer.
More information is available online through the Ethics Commission’s lobbying program and publication pages. For assistance, please contact the Ethics Commission.
Information and Procedure Bulletins
| LIC-4001-IPB | PCN Information and Procedure Bulletin |
| LIC-4002-IPB | Pre-application Review Information and Procedure Bulletin |
| LIC-4003-IPB | Temporary Approval Information and Procedure Bulletin |
| LIC-4004-IPB | Application Modification: Business Premises Relocation Information and Procedure Bulletin |
| SEP-6001-IPB | Social Equity Program - Entity Verification Information and Procedure Bulletin |
Public Convenience or Necessity Forms and Documents
| LIC-4001-IPB | PCN Information and Procedure Bulletin |
| LIC-4001-WF | PCN Workflow |
| LIC-4001-FORM | Public Convenience or Necessity Finding Request ("PCN Request Form") |
| LIC-4002-FORM | Stakeholder Input Request |
Pre-Application Review Forms and Documents
| LIC-4002-IPB | Pre-Application Review Information and Procedure Bulletin |
| LIC-4002-WF | Pre-Application Review Workflow |
| LIC-4016-FORM | Landowner Attestation: Location Eligibility |
Temporary Approval Forms and Documents
| DCC Document | Business Premises Diagram Reference Guide |
| LIC-4003-IPB | Temporary Approval Information and Procedure Bulletin |
| SEP-6001-IPB | Social Equity Program - Entity Eligibility Verification Information and Procedure Bulletin. |
| LIC-4005-WF | Temporary Approval Application Refiling Workflow |
| DCR FORM | Sample Inspection Checklist Retail |
| LIC-4003-FORM | List of Primary Personnel and Owner(s) |
| LIC-4004-FORM | Primary Personnel and Owner Attestation |
| LIC-4005-FORM | Indemnification Agreement |
| LIC-4006-FORM | Labor Peace Agreement Attestation |
| LIC-4007-FORM | Landowner Attestation: Commercial Cannabis Activity |
| LIC-4008-FORM | Legal Business Entity Record Disclosure Form |
| LIC-4010-FORM | Temporary Approval Attestation |
| LIC-4020-FORM | No Alcohol or Tobacco Applicant Attestation |
| LIC-4021-FORM | Initial Inspection Attestation |
| SEP-6001-FORM | Social Equity Program - Owner Compliance Attestation |
In addition to the DCR forms, the Temporary Approval Process requires that the Applicant submit following documents:
- Executed Lease Agreement or Property Deed, or Other Evidence of Legal Right to Occupy
Renewal Forms and Documents
| DCC Document | Business Premises Diagram Reference Guide |
| LIC-4005-FORM | Indemnification Agreement |
| LIC-4013-FORM | Project-Specific Information |
| LIC-4017-FORM | Renewal Attestation |
| LIC-4024-FORM | Business Premises Diagram Checklist |
In addition to the DCR forms, the Renewal Process requires that the Applicant submit following documents:
- Executed Lease Agreement or Property Deed, or Other Evidence of Legal Right to Occupy
Social Equity Program Forms and Documents
| SEP-6001-IPB | Social Equity Program - Entity Verification Information and Procedure Bulletin |
| SEP-6001-FORM | Social Equity Program - Owner Compliance Attestation |
| SEP-6001-CS | Equity Share Review Checklist |
| SEP-6002-FORM | Pro Bono/Low Bono Authorization Agreement |
| SEP-6003-FORM | Asset Attestation |
| SEP-6004-FORM | One-On-One Coaching Indemnification Form |
Application Modification Forms and Documents
Applicants and licensees seeking to request an Application/License modification must fill out the "Application Modification Request - Cover Page" along with the specific modification request form. Modification request forms are intended for use in DCR's Licensing Portal (Accela). Please do not submit official documents via email.
| LIC-4004.1-WF | Application Modification: General Modification Request Workflow |
| LIC-4004-WF | Application Modification: Business Premises Relocation Workflow |
| LIC-4004-IPB | Application Modification: Business Premises Relocation Information and Procedure Bulletin |
| LIC-4001-MOD | Application Modification Request Cover Page |
| LIC-4002-MOD | Application Modification Request - Business Premises Relocation |
| LIC-4004-MOD | Application Modification Request - Ownership Structure |
| LIC-4005-MOD | Application Modification Request - Removal of Owner(s) |
| LIC-4006-MOD | Application Modification Request - Applicant Entity Substitution (General) |
All Application Forms (in Numerical Order)
| DCC Document | Business Premises Diagram Reference Guide |
| LAFD FORM | Statement of Intended Use |
| DCR FORM | Sample Inspection Checklist Retail |
| ENF-3001-FORM | Administrative Hearing Request |
| ENF-3003-FORM | Licensee Attestation: Operational Rules and Regulations (revised 02.21.2024) |
| ENF-3004-FORM | Cannabis Delivery Vehicle Fleet Information |
| ENF-3005-FORM | Extension of Time to Comply with NOV |
| LIC-4001-FORM | Public Convenience or Necessity Finding Request |
| LIC-4001-MOD | Application Modification Request Cover Page |
| LIC-4002-FORM | Stakeholder Input Request |
| LIC-4002-MOD | Application Modification Request - Business Premises Relocation |
| LIC-4004-FORM | Primary Personnel and Owner Attestation |
| LIC-4004-MOD | Application Modification Request - Ownership Structure |
| LIC-4005-FORM | Indemnification Agreement |
| LIC-4005-MOD | Application Modification Request - Removal of Owner(s) |
| LIC-4006-FORM | Labor Peace Agreement Attestation |
| LIC-4006-MOD | Application Modification Request - Applicant Entity Substitution (General) |
| LIC-4007-FORM | Landowner Attestation: Commercial Cannabis Activity |
| LIC-4008-FORM | Legal Business Entity Record Disclosure Form |
| LIC-4009-FORM | Authorized Agent Acknowledgement |
| LIC-4010-FORM | Temporary Approval Attestation |
| LIC-4013-FORM | Project-Specific Information |
| LIC-4014-FORM | Denial of an Annual License Appeal Form |
| LIC-4015-FORM | Application Withdrawal - License Cancellation |
| LIC-4016-FORM | Landowner Attestation: Location Eligibility |
| LIC-4017-FORM | Renewal Attestation |
| LIC-4018-FORM | Successor In Interest Form |
| LIC-4019-FORM | Business Premises Surrender Form |
| LIC-4020-FORM | No Alcohol or Tobacco Applicant Attestation |
| LIC-4021-FORM | Initial Inspection Attestation |
| LIC-4022-FORM | Receivership Form |
| LIC-4023-FORM | Phase 2 (LAMC 104.08) Tier 3 Applicant Attestation |
| LIC-4024-FORM | Business Premises Diagram Checklist |
| SEP-6001-FORM | Social Equity Applicant - Owner Compliance Attestation |
| SEP-6002-FORM | Pro Bono/Low Bono Authorization Agreement |
| SEP-6003-FORM | Asset Attestation |
| SEP-6004-FORM | One-On-One Coaching Indemnification |