Addition/Change of Controlling Person

To propose changing a Controlling Person to an already issued license, complete and submit the information below and return by email to ccd.licensing@state.nm.us or mail to Cannabis Control Division 1209 Camino Carlos Rey Santa Fe, NM 87507.

A Controlling Person means a person that controls a financial or voting interest of ten percent or more of, or and officer or board member of, a cannabis establishment; and does not include a bank or licensed lending institution. This form cannot be used to change any details of a license, other than the addition of a Controlling Person.
If a Controlling Person is proposed to be added to provide the following information and include proof the controlling person is at least 21 years of age, which shall include identification issued by a federal or state government that includes the name, date of birth, and picture of the controlling person.
Name of Proposed Controlling Person:
Mailing Address:
Is Proposed Controlling Person a New Mexico resident?
Preferred Gender Pronoun:
Has Proposed Controlling Person ever legally changed their name or used a different name for employment or school?
Please specify race: (Check all that apply)
Please specify ethnicity: (Check all that apply)
Gender
Has Proposed Controlling Person, or a business entity in which the Proposed Controlling Person was associated been:
(1) denied a license or had a license suspended or revoked by the division or any other state cannabis licensing authority; or (2) had any administrative orders, or sanctions for unlicensed cannabis activity by any state licensing authority, against the proposed controlling person within the three years immediately preceding the date of this application to add a Controlling Person:
*If the answer to the question above is yes, Proposed Controlling Person(s) must provide a detailed description, as an attachment to this application, of any administrative orders, civil judgments, denial or suspension of a cannabis license, revocation of a cannabis license, or sanctions for unlicensed cannabis activity by any state licensing authority, against the proposed controlling person, or a business entity in which the proposed controlling person was a controlling person within the three years immediately preceding the date of this application.
Has the Proposed Controlling Person ever been convicted of the following crime(s):
  • A felony conviction involving fraud, deceit, or embezzlement;
  • A felony conviction for hiring, employing, or otherwise using a person younger than eighteen years of age to:
      a. Prepare for sale, transport or carry a controlled substance; or,
      b. Sell, give away or offer to sell a controlled substance to any person;
  • A felony offense for the possession use, manufacture, distribution or dispensing or possession with the intent to manufacture, distribute or dispense a controlled substance, which no longer includes cannabis.
**If the answer to the question above is yes, Controlling Person must provide, as an attachment to this application, a detailed description of any criminal convictions, including for each: the date of the conviction; dates of incarceration, probation, or parole; description of the offense; and any evidence of rehabilitation, including court documents, personal or professional references, completion of treatment, employment records, and other relevant information.
Proposed Controlling Person consents to submit a background screening request, including an authorization for release of information, for a current New Mexico state criminal history report.
Submitted by:
Printed Name:
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For Cannabis Control Division Use Only:

Decision by Director
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with copy by:
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