Edit, Download, and Sign the Nevada Cannabis Compliance Board Agent Card Application

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How do I fill this out?

To fill out the application form, ensure all required fields are completed, provide necessary documentation, and sign where indicated. Submit the form and payment as instructed. Follow specific instructions for fingerprint submission.

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How to fill out the Nevada Cannabis Compliance Board Agent Card Application?

  1. 1

    Fill out all required agent registration forms completely.

  2. 2

    Provide government-issued identification and a passport photo.

  3. 3

    Submit fingerprint cards and background waiver forms.

  4. 4

    Include the $75.00 registration fee for each establishment category.

  5. 5

    Submit the completed application via the TaxAgentPortal or by mail.

Who needs the Nevada Cannabis Compliance Board Agent Card Application?

  1. 1

    Business owners in the cannabis industry requiring employee registration.

  2. 2

    Cannabis establishment officers needing compliance verification.

  3. 3

    Volunteers at cannabis establishments.

  4. 4

    Contractors working with cannabis establishments.

  5. 5

    Employees of cannabis-related businesses.

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What are the instructions for submitting this form?

Submit the completed form and payment via the TaxAgentPortal.nv.gov for the most efficient processing. If mailing, send the application documents to: CCB, Attn: Agent Cards, P.O. Box 1948, Carson City, Nevada 89701. Ensure all forms have original signatures and include all required documents. Do not mail documents to the Department of Public Safety. For any issues, contact the Board at CCBLicensing@CCB.nv.gov. Advice: Double-check all required forms and ensure payment is included to avoid delays.

What are the important dates for this form in 2024 and 2025?

The agent registration card is valid for one year from the date of issue. Renewals must be submitted at least 30 days before expiration to avoid a lapse in employment. Stay updated with important submission deadlines on the Nevada Cannabis Compliance Board website.

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What is the purpose of this form?

The purpose of this form is to ensure proper registration and compliance for individuals working in the cannabis industry in Nevada. By obtaining an agent registration card, applicants demonstrate their eligibility and commitment to adhering to state regulations. This process promotes a standardized approach to managing personnel within the industry, ensuring security, training, and legal compliance.

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Tell me about this form and its components and fields line-by-line.

The form comprises several key sections that must be filled out accurately to ensure compliance.
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  • 1. Agent Basic Information Document: This section requires the applicant to provide personal details and contact information.
  • 2. Government-Issued Identification: Provide copies of both front and back of a valid ID such as a driver's license or passport.
  • 3. Applicant Required Attestation Form: Includes declarations and signatures attesting to the applicant's eligibility.
  • 4. Applicant Dispense/Divert Pledge Form: A pledge by the applicant related to the handling of cannabis products.
  • 5. Passport Photo and Signature: Submit an original passport photo and a signature as per specified requirements.
  • 6. Fingerprint Background Waiver: A two-page waiver form required for state and federal background checks.
  • 7. Registration Fee: A $75.00 fee per establishment category applied for, payable to the State of Nevada.
  • 8. Applicant Fingerprint Submission Form: Complete the form and follow instructions for LiveScan or Fingerprint/Ink Card submission.

What happens if I fail to submit this form?

Failing to submit this form on time may result in delays or denial of registration.

  • Employment Issues: Delayed submission could lead to a lapse in employment due to an expired registration card.
  • Non-Compliance: Failure to register may result in the individual being non-compliant with state regulations.
  • Penalties: Non-submission could attract legal penalties or fines for the applicant or their employer.

How do I know when to use this form?

Use this form when applying for or renewing a Nevada Cannabis Establishment Agent Card.
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  • 1. New Application: When applying for the first time as a cannabis establishment agent in Nevada.
  • 2. Renewal Application: When renewing an existing agent registration card before it expires.
  • 3. Lost Card Replacement: To replace a lost, stolen, or destroyed agent registration card.
  • 4. Address or Name Change: To update personal information on an existing agent registration card.
  • 5. Background Check Update: When submitting new fingerprint cards for background checks.

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