Required Documents

Below is a checklist of the documents required to be uploaded as part of the LEEP Eligibility application. A downloadable version of the checklist is available here.

Jurisdiction and Permit/License Requirement Documentation

Please provide one of the following:

Option 1: Copy of an issued Cannabis Cultivation / Cannabis Facilities Business License

Option 2: Copy of a Cannabis Cultivation Application Receipt or a Cannabis Facilities Business License Application Receipt

Option 3: For those who have not applied yet for a Cannabis related permit/license a business address jurisdiction verification form found here.

Low Income Requirement Documentation

You will need to meet the household limit requirements found here. Please provide the following as evidence:

Personal Financial Statement found here

Most recently filed required federal income tax return. 2019 federal tax returns will only be accepted until April 15, 2021.

Equity Requirement Documentation

Please provide documentation that you meet one (1) of the following five (5) equity qualifications summarized in Qualifications A - E below. Note that you only need to meet one of the five and not all five qualifications:

Qualification A: Have lived within a 5-mile radius of the location of raids conducted by the Campaign Against Marijuana Planting (CAMP) program. As evidence, please upload two (2) documents from the list below:

1) Proof of residency on the date of the CAMP raid. The address listed in your application must meet the 5 mile radius criteria and verify you lived at the location at the time of the CAMP raid. Acceptable documents that meet this requirement include:

• Utility Bill

• Lease or Rental Agreement(s)

• Deed or Titles to a Residential Property

• Medical or Employee Documents

• Mortgage

• Voter Registration Records

• Camp Raid Neighbor Statement Form found here which is signed by a Neighbor of the LEEP Applicant that lived at that location at the time of the raid.

2) Proof of the date and location of the CAMP raid listed in your application. Acceptable documents that meet this requirement include:

• CAMP raid witness declaration stating the date and location the raid occurred.

• Newspaper Article

• Journal Article

• Media Report

• Hearing Records

• Court Records

• Arrest Records

• Seizure Receipt

• Declaration from an attorney

• Law Enforcement Activity Report

• Restitution fine receipts

Qualification B: Have 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).

Please upload one of the following records as proof of the arrest or conviction:

• Arrest Record

• Court Record

• Declaration from an Attorney familiar with your family’s arrest/conviction history

• Record of booking (from a booking log )

Qualification C: Any individual who has obtained or applied for a cannabis permit in Mendocino County, or who has worked in or currently works in the cannabis industry, and was arrested and or convicted of a non-violent cannabis-related offense, or was subject to asset forfeiture arising from a cannabis related event. Please upload two (2) of the following:

1) Cannabis Work Experience Form found here. The complete form provides information about your current or previous work in the cannabis industry and provides a name and phone number of a work reference if available.

2) Please upload one (1) of the following records as proof of the arrest or conviction:

• Arrest Record

• Court Record

• Declaration from an Attorney familiar with your arrest/conviction history

• Seizure Receipt

• Record from a booking log

Qualification D: Is a person who experienced sexual assault, exploitation, domestic violence, and/or human trafficking while participating in the cannabis industry. As confirmation, please provide the following:

1) Cannabis Work Experience Form found here. The complete form provides information about your current or previous work in the cannabis industry and provides a name and phone number of a work reference if available.

2) Please upload (1) one of the following record types as evidence:

• Court Record

• Police Report

• Declaration from an Attorney familiar with your case

• Domestic violence service provider, Crisis Center, or Therapist Report

• A letter of support from a counselor, family member or friend that can confirm your narrative.

Qualification E: Have become homeless or suffered a loss of housing as a result of cannabis enforcement. As confirmation, please provide the following:

1) Cannabis Work Experience Form found here. The complete form provides information about your current or previous work in the cannabis industry and provides a name and phone number of a work reference if available.

2) Please upload one (1) of the following record types to demonstrate a loss of housing as result of cannabis enforcement.

• Court Record

• Landlord Eviction Notice

• Homeless Assistance Enrollment Record (such as HMIS)

• A letter of support from a counselor, family member or friend who can support your narrative.

• Homeless services provider statement

• Foreclosure documentation

State Demographic Questionnaire

To see an example of the State Demographic Questionnaire, click here.

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