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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section 1, 'Applicant Identification.' Enter your name or business name, mailing address, and contact information. Ensure all details are accurate to avoid processing delays.
In Section 2, select your business activity by checking only one box that applies to your operations. This is crucial as each activity requires a separate application.
Proceed to Section 3, where you will indicate the schedules of controlled substances you handle. Be thorough in checking all applicable boxes.
Complete Section 4 by providing any state license numbers required for your operation. This ensures compliance with local laws.
Answer all questions in Section 5 regarding liability. If you answer 'Yes' to any question, provide detailed explanations as instructed.
In Section 6, check the exemption box if applicable and provide the certifying official's details.
Choose your payment method in Section 7 and ensure you sign in Section 8 to validate your application.
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