Deferment of Fees Request

Enter the name of the Individual, Company or Society applying for deferment
Information of the Individual/Authorized Agent Making the Request
Enter your first name
Enter your middle name
Enter your last name
Identification Type

Select your ID type
Enter the identification number
Enter Home Address if you are an Individual or Registered Address of the Business/Company/Society
Enter your contact telephone number(s)
more items
Check the licence type(s)
Indicate which fee you are requesting to be deferred
Please check the appropriate deferment arrangement payment option being requested
Declarations

I hereby request to defer the payment of licence fee and/or security bond in accordance with Regulation 32 oftheDangerous Drugs(Cannabis Licensing) (Interim) Regulations, 2016 and agree as follows:
 

  1. That the request for deferment of Licence Fee and/or Security Bond is not guaranteed and is subject to the evaluation of the application by the Board of Directors of the Cannabis Licensing Authority (CLA) in accordance with the Dangerous Drugs (Cannabis Licensing) (Interim) Regulations, 2016 and the CLA’s Policy on the Deferment of Licence Fee and Security Bond.
  2. That, if approved, I will pay the Licence Fee and/or Security Bond in accordance with the terms agreed with the Authority.
  3. That all information provided in this Deferment Request Form is correct and true to the best of my knowledge information and belief.
  4. That I agree to allow the CLA to obtain information from any third-party source and to use that information,to form part of the consideration for this application.
  5. That I will provide the Authority with any additional document requested, to assist with the evaluation of this application.
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