A-367 Nunavut Cannabis Retailer Application Form

Nunavut Cannabis Retailer Application Form

Under the Cannabis Act (Nunavut), the undersigned entity is applying for a licence to retail cannabis in Nunavut.

Applicant Name

Phone

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Business Name

Head Office Mailing Address

City/Town

State/Province

ZIP/Postal Code

Business Structure (select one)

Corporation

Partnership

Sole Proprietor

Company

Other:

Enter other…

Personal Information of all Business Partners/Equity Participants

Name	Address	Email	Phone	Date of Birth	Shares Held
Name	Address	Email	Phone	Date of Birth	Shares Held
Name	Address	Email	Phone	Date of Birth	Shares Held
Name	Address	Email	Phone	Date of Birth	Shares Held
Name	Address	Email	Phone	Date of Birth	Shares Held
Name	Address	Email	Phone	Date of Birth	Shares Held

Steps

Current Nunavut Cannabis Retailer Application Form
Cannabis Store Information
Document Checklist (check all documents that have been included with this application)
Declaration
Preview
Complete