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Application for a Cannabis Licence under the Narcotic Drugs Act 1967
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Application for a Cannabis Licence under the Narcotic Drugs Act 1967
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Introduction

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Before starting your application

This application is for stakeholders who are applying for a (new) licence under the Narcotic Drugs Act 1967 to cultivate, produce and/or manufacture cannabis, or cannabis material, for the purposes of patient supply or research. This application is open to individuals or organisations that believe they can meet all regulatory requirements prescribed in the relevant Commonwealth legislation:

Narcotic Drugs Act 1967
Narcotic Drugs Regulation 2016
The publication Completing an on-line cannabis licence application is provided on the Office of Drug Control (ODC) website to assist in the completion of the on line application. It is advisable that this is read prior to, or in conjunction, with completing this on-line application. This application is not received for processing by the ODC until submitted. Draft applications are not visible to the ODC and do not undergo processing. If unchanged for 14 days, a draft application will automatically delete. This application is for a new licence and cannot be used by an existing licence holder to vary details of a current licence.

Attachments

There is a total attachment size limit of 20 MB if you reach or exceed the limit you will be unable to attach further files to this form. You can select to add further attachments using the continuation form. Just select the checkbox on the Lodgement section of this form and we will automatically send you an additional continuation form to the email address you supply in this form. You will need to complete the continuation form within 14 days for your whole application to be submitted for processing by the ODC. If you do not submit the continuation form within 14 days your whole application will not be submitted to the ODC and will be deleted.

Record checks

The ODC may validate any information provided in this application with Commonwealth, State and Territory law enforcement authorities, and, State and Territory regulatory, planning and/or infrastructure authorities.

Fees

A fee of AUS $ will be attracted by an application for a medicinal cannabis or cannabis research licence. Payment is required upon receiving an invoice for the amount from the Australian Government Department of Health. The application fee is non-refundable.

Providing incorrect information

It is a serious offence for a person to knowingly make a false or misleading statement in relation to an application - see Division 136 and 137 of the Criminal Code Act 1995. Significant fines apply.

Privacy

The ODC collects a variety of personal information in the course of performing its function. Personal information is defined in the Privacy Act 1988 (Cth)(Privacy Act). Your personal information is protected by law under the Privacy Act, which contains the Privacy principles. The ODC is part of the Australian Government Department of Health. The Privacy Policy for this Department is available at www.health.gov.au

Google Places

The Address search fields in this form use Google Places to help fill in the address details. By using this feature you agree to be bound by Google's Terms of Service and are subject to Google's Privacy Policy.

After you lodge your application

The lodgement of an application for a medicinal cannabis licence is not in, or of, itself any form of approval to commence or continue activities involving cannabis or cannabis material. Such actions may be unlawful. Do not provide monies until issued with an invoice for the fees attracted by the application. If you become aware that information provided in a recently submitted application is incorrect, then the specifics should be immediately emailed to mcs@health.gov.au. The impact of the incorrect data upon the application will be considered on a case-by-case basis. If you decide to withdraw your application, then an email to this affect should be immediately sent to mcs@health.gov.au. Please note that the application fee is non-refundable. The ODC may request additional information to supplement that provided in a lodged application in order to reach a decision. Please note the ODC may approach you for further information more than once in the course of assessing your application.

Applicant details

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Proposed licence holder

Is the proposed licence holder an/ a:

Name

Please attach three (3) certified true proof of identify documents consisting of a combination of the following, with at least one from Category A. * Category A
A birth certificate issued by a State or Territory A current passport issued by the Commonwealth A citizenship certificate issued by the Commonwealth or a certificate of registration by descent Foreign passport
Category B
A driver’s licence or learner’s permit issued under a State or Territory law (must include a photo of the applicant, applicant’s signature and a street address the same as their address stated in the application A Medicare card A permanent visa (within the meaning of the Migration Act 1958) that is in effect in relation to the applicant Documentary evidence that the applicant is an Australian permanent resident within the meaning of the Migration Act 1958
File:

Name

Enter your business name to get a list of related ABNs

Contact details

Address

Address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy.To summarise

Your Terms of Use and Privacy Policy must be publicly available.You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service.You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.

Details of people authorised to discuss and provide information for this application

Authorised person details
Authorised person of

Site details

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Site address

Site address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy.To summarise

Your Terms of Use and Privacy Policy must be publicly available.You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service.You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.

GPS coordinates

Is the land owned by the applicant?
Is the land leased by the applicant?

Lessor details

Site owners address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Is this an Australian or international address?
Attach a site plan showing how the land will be used for the proposed licensed activities.
File:
Attach a floor plan of the premises and facilities where the licensed activities will be undertaken
File:

Other premises

Provide the addresses of any other premises at which other activities relating to the proposed licensed activities will be carried out.
Provide the addresses of any other premises at which other activities relating to the proposed licensed activities will be carried out.
Other premise of
Other premise address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy.To summarise

Your Terms of Use and Privacy Policy must be publicly available.You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service.You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Attach a site plan showing how the land will be used for the proposed licensed activities
File:
Attach a floor plan of the premises and facilities where the licensed activities will be undertaken
File:
Has the applicant applied for, or intends to apply for, another licence under the Narcotic Drugs Act 1967?

Other licence applications

Other licence application of

Site details

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Site address

Site address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy.To summarise

Your Terms of Use and Privacy Policy must be publicly available.You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service.You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.

GPS coordinates

Is there a known end date for the occupancy of the proposed site?
Are there any terms and conditions of occupancy of the site that could conflict with the grant of the licence?
Are there any other businesses collocated with the proposed site?
Are there any other activities that occur at the site that are not related to the proposed licence?
Attach a site plan showing how the land will be used for the proposed licensed activities.
File:
Attach a floor plan of the premises and facilities where the licensed activities will be undertaken
File:

Other premises

Provide the addresses of any other premises at which other activities relating to the proposed licensed activities will be carried out.
Provide the addresses of any other premises at which other activities relating to the proposed licensed activities will be carried out.
Other premise of
Other premise address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy.To summarise

Your Terms of Use and Privacy Policy must be publicly available.You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service.You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Attach a site plan showing how the land will be used for the proposed licensed activities
File:
Attach a floor plan of the premises and facilities where the licensed activities will be undertaken
File:
Has the applicant applied for, or intends to apply for, another licence under the Narcotic Drugs Act 1967?

Other licence applications

Other licence application of

Fit and proper person

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required
Have you been convicted, at any time, of an offence against a law of the Commonwealth, a State or Territory or a another country?
Have you engaged in conduct (which may or may not have led to a conviction) constituting a serious offence involving cultivation, supply or use of cannabis?
Have you ever had a civil penalty imposed upon, at any time, under a law of the Commonwealth, a State or a Territory?
Have you ever had a licence or permit (however described) revoked or suspended under a law of the Commonwealth, a State, a Territory or another country, being a law relating to the prohibition or regulation of drugs?

Please list any connections or associations you have with other people that may affect your reputation, character, honesty or professional or personal integrity

Connection/association of

Please list below each person who holds a relevant financial interest, or who is entitled to exercise a relevant power (either in their own right on behalf of another person), in relation to:1) your business undertaking the activities to which this application relates; and/or2) any other business you undertake and provides a substantial portion of your income.

Please list below each person who holds a relevant financial interest, or who is entitled to exercise a relevant power (either in their own right on behalf of another person), in relation to:
1.your business undertaking the activities to which this application relates; and/or 2.any other business you undertake and provides a substantial portion of your income.
Person of
Do you hold, or have you ever held, a professional qualification issued under a law of the Commonwealth, a State or a Territory, where you have been subject to disciplinary or other action relating to that qualification?
Are you currently affected by bankruptcy?

Please advise the details of any licence, issued under the Narcotic Drugs Act 1967, that you currently hold or have previously held

Licence of
Is the licence:
Are there any issues relating to your compliance with the Narcotic Drugs Act 1967?
Attach a resume detailing your previous business experience
File:
Attach evidence (e.g. a bank statement or audited financial background) that you have a sound and stable financial background and that there are no financial circumstances that may limit your ability to comply with the licence holder's obligations under the Narcotic Drugs Act 1967
File:
Attach a copy of a National Police Check Certificate issued by the Australian Federal Police, State or Territory police force for each person employed by the applicant to carry out the activities authorised by the licence.
File:

Fit and proper person

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Please list the names and dates of birth of all directors and officers of the body corporate

Director/officer of
Has this director/officer been convicted at any time of an offence against a law of the Commonwealth, a State or a Territory or another country?
Attach a resume detailing the previous business experience for this director/officer
File:
Attach a copy of a National Police Check Certificate issued by the Australian Federal Police, State or Territory police force for this director/officer
File:
Has any director or officer of the body corporate, or the body corporate been convicted at any time of an offence against a law of the Commonwealth, a State or a Territory or another country?
Was the offence concerned committed at a time when any person who is presently a director or officer of the body corporate, was a director or officer of the body corporate?
Was the offence concerned committed at a time when any shareholder who is presently in a position to influence the management of the body corporate, was a shareholder?
Has the body corporate, or any director(s) of the body corporate, engaged in conduct (which may or may not have led to a conviction) constituting a serious offence involving cultivation, supply or use of cannabis?
Has any director or officer of the body corporate, or the body corporate, ever had a civil penalty imposed upon them, at any time, under a law of the Commonwealth, a State or a Territory?
Was the conduct to which the civil penalty relates at a time when any person who is presently director or officer of the body corporate, was a director or officer of the body corporate?
Was the conduct to which the civil penalty relates at a time when any shareholder who is presently in a position to influence the management of the body corporate, was a shareholder?
Has any revocation or suspension of a licence or permit (however described) held by the body corporate occurred under a law of the Commonwealth, a State, a Territory or another country, being a law relating to the prohibition or regulation of drugs?

Please list below any connections or associations the body corporate, its directors or officers have with other people that may affect the reputation, character, honesty, or professional or personal integrity of the directors or officers

Connection/association of

Name

Please list below each person who holds a relevant financial interest, or who is entitled to exercise a relevant power (either in their own right or on behalf of another person), in relation to:
the body corporate undertaking the activities to which this application relates; and/orany other business the body corporate undertakes and provides a substantial portion of its income.

Connection/association of

Name

Do any directors or officers of the body corporate hold, or have they ever held, a professional qualification issued under a law of the Commonwealth, a State or a Territory, where they have been subject to disciplinary or other action relating to that qualification?
Does the body corporate hold, or has previously held, a licence issued under the Narcotic Drugs Act 1967?

Existing licence

Existing licence of
Are there any issues you wish to bring to the attention of the ODC relating to the body corporate’s compliance with the Narcotic Drugs Act 1967?
Attach evidence (e.g. a bank statement or audited financial statement) that the body corporate has a sound and stable financial background and that there are no financial circumstances that may limit its ability to comply with a licensee’s obligations under the Narcotic Drugs Act 1967
File:
Attach a copy of a National Police Check Certificate issued by the Australian Federal Police, State or Territory police force for each person employed by the applicant to carry out the activities authorised by the licence.
File:

Fit and proper person

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Fit and proper person

Important: Legislative requirements for Fit and Proper Person In deciding this application, the delegate must be satisfied that Fit and Proper Person requirements will be met through your agency’s practices governing the persons authorised to control authorised activities (if the licence were granted).

Licence details

Application for a Cannabis Licence under the Narcotic Drugs Act 1967
Fields marked with * are required

Licence type

This application is for a:
This application is for a:

Medicinal cannabis licence

Psychoactive content

Important: Where the applicant selects to operate with cannabis materials containing <1% w/w THC or equivalent in THCA, the licence will be conditioned accordingly.
Cannabis materials, for which the licence is sought
What activities involving medicinal cannabis is the licence to authorise?

Activities

Confirm the full range of activities sought for authorisation In normal operations, some activities involving cannabis may need to occur off site. Your application must declare the situations in which this will occur. Importantly, even when the cannabis leaves a licenced site, the cannabis remains under the control of the licence holder. For example, when a sample is sent to a laboratory for testing or during transportation by a contracted specialist.
Identify the scenarios when cannabis will leave the site nominated in your application

Cannabis research licence

This applicant is seeking the licence for:

Psychoactive content

Important: Where the applicant selects to operate with cannabis materials containing <1% w/w THC or equivalent in THCA, the licence will be conditioned accordingly.
Cannabis materials, for which the licence is sought
The applicant would like to apply for a Cannabis Research licence to:
The applicant would like to apply for a Cannabis Research licence to:

Activities

Confirm the full range of activities sought for authorisation In normal operations, some activities involving cannabis may need to occur off site. Your application must declare the situations in which this will occur. Importantly, even when the cannabis leaves a licenced site, the cannabis remains under the control of the licence holder. For example, when a sample is sent to a laboratory for testing or during transportation by a contracted specialist.
Identify the scenarios when cannabis will leave the site nominated in your application
Please attach a resume detailing the qualifications and expertise of the applicant to carry out such research.
File:

Manufacturing licence for Narcotic Drugs

Application type – Licence to manufacture
Manufacturing activities to be undertaken
‘Manufacture’ means all processes, other than production, by which drugs may be obtained and includes refining as well as the transaformation of drugs into other drugs.

Drugs being manufactured

Drug of
Do you intend to manufacture a drug that includes, or is derived from, any part of the cannabis plant?
Is the drug for the purpose of research relating to medicinal cannabis products?
Please attach a resume detailing the qualifications and expertise of the persons employed or engaged by the applicant to carry out such research.
File:
Is the drug a medicinal cannabis product?
Is the drug to be supplied to the public?
Is the drug to be used in a clinical trial?
Is the drug proposed to be manufactured, a medicinal cannabis product?
Please download and complete a manufacturing schedule. Upload the completed manufacturing schedule.
File:

Research

Does the research relate to medicinal cannabis products?

Medicinal cannabis product

Will the product be used in a clinical trial?
Will the product be supplied to the public?

Other activities (other than research and manufacture)

State / Territory Government licence(s)

Other licence applications
Other licence of