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Marijuana Business Individual History Form

Marijuana Business Individual History Form 2025

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The Marijuana Business Individual History Form is a required document for individuals applying for a marijuana license in Oregon. Each applicant must complete their own form, providing personal history information, including consent for the use of their Social Security Number for identity verification. The form also requires disclosure of any felony convictions or unresolved arrests. Applicants must sign the form and notify the Oregon Liquor Control Commission (OLCC) of any legal issues that arise after submission.

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Click ‘Get Form’ to open the Marijuana Business Individual History Form in our editor.
Begin by filling out Section 1, the Individual History Statement. Enter your first name, middle initial, and last name, followed by your date of birth. Ensure accuracy as this information is crucial for your application.
Next, indicate your gender and provide your mailing address, including city, state, ZIP code, contact phone number, and email address. If you have a Social Security Number (SSN), enter it in the designated field; otherwise, select the option indicating you do not have one.
Respond to the questions regarding felony convictions and unresolved arrests or citations. If applicable, attach explanations as required.
List any OLCC liquor or marijuana licenses you have applied for or held in the provided section. This includes any financial interests in related businesses.
In Section 2, acknowledge that you must sign your own form. Review all entries for accuracy before signing and dating the form.

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Versions	Form popularity	Fillable & printable
2022	4.1 Satisfied (47 Votes)
2021	4.9 Satisfied (23 Votes)
2020	4.4 Satisfied (242 Votes)
2017	4.4 Satisfied (45 Votes)

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