LEEP Equity Application

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The below application is for individuals who wish to apply for Local Equity Certification and meet one of the below criteria. If applying, please choose up to one of the following criteria and ensure to upload supporting material(s) for each criterion you are applying for. The Department will send you an eligibility certificate if approved.

Please note, this is NOT an application for Fee Relief or Direct Grant Funding.

Local Equity Entrepreneurial Program (LEEP) Equity Criteria:

Any individual who has worked in or currently works in the cannabis industry, who has obtained, applied for, or will apply for a cannabis CCBL in Mendocino County, and owns at least 50% of the business and meets one of the following equity criteria:

Please correct the fields below:

Please correct the field(s) marked in red below:

1

Name:

*

Name:

First

Last

2

Contact Information:

*

Contact Information:

Email Address:

Phone Number:

Physical Address:

Mailing Address:

3

What is the name of your business' legal structure (LLC, Sole Proprietorship, etc.)?

*

What is the name of your business' legal structure (LLC, Sole Proprietorship, etc.)?

Business Name

Business Legal Structure

Percentage of Ownership

4

Cannabis Cultivation Business License or Cannabis Facility Business License Information:

*

Cannabis Cultivation Business License or Cannabis Facility Business License Information:

How many Cannabis Business Licenses have you applied for?

What is your Accela (ex. CAN-N-2023-3025) or TRAKiT (ex. CFBL_2023_3035) record ID number?

5

Upload an image of the LEEP candidate's driver's license, passport, or other government-issued ID to verify identity.

*

Upload an image of the LEEP candidate's driver's license, passport, or other government-issued ID to verify identity.

Click button for uploading file

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Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

6

Select which qualification(s) you will provide documentation for (please see the DCC Mapping Tool here):

*

Select which qualification(s) you will provide documentation for (please see the DCC Mapping Tool here):

Lived in a place for at least 5 years between 1980 and 2016 that was a California county with drug arrest rates that were higher than the state average drug arrest rates and: The top 25% for unemployment and poverty. Please use the DCC Mapping Tool above to see if your address qualifies.

Any individual who was arrested and/or convicted of a non-violent cannabis-related offense prior to November 8, 2016, or who has a parent, sibling or child who was arrested for or convicted of the sale, possession, use, manufacture or cultivation of cannabis (including as a juvenile) prior to November 8, 2016.

Any individual who was personally raided or was subject to asset forfeiture arising from a cannabis-related event.

Are a person who experienced sexual assault, exploitation, domestic violence, and/or human trafficking while participating in the cannabis industry.

Your household income is no more than 60% of the area’s median income, or you’re eligible to get financial aid through a program like: CalFresh, MediCal, CalWORKS, Supplemental security income, Social Security disability.

Have become homeless or suffered a loss of housing as a result of cannabis enforcement.

7

Upload Proof of Eligibility:

Lived in a place for at least 5 years between 1980 and 2016 that was a California county with drug arrest rates that were higher than the state average drug arrest rates and: The top 25% for unemployment and poverty. Please use the DCC Mapping Tool to see if you have a qualifing address.

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Any individual who was arrested and/or convicted of a non-violent cannabis-related offense prior to November 8, 2016, or who has a parent, sibling or child who was arrested for or convicted of the sale, possession, use, manufacture or cultivation of cannabis (including as a juvenile) prior to November 8, 2016. (You can show proof of conviction or arrest using one of the following: (1) Copies of federal, state, or county court records that show the outcome of the case (2) Records showing dismissal or expungement (3) Any other court or law enforcement record that show proof of conviction or arrest)

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Any individual who was personally raided or was subject to asset forfeiture arising from a cannabis-related event.

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Are a person who experienced sexual assault, exploitation, domestic violence, and/or human trafficking while participating in the cannabis industry.

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Have become homeless or suffered a loss of housing as a result of cannabis enforcement.

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Your household income is no more than 60% of the area’s median income, or you’re eligible to get financial aid through a program like: CalFresh, MediCal, CalWORKS, Supplemental security income, Social Security disability.

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

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