North Carolina Industrial Hemp Commission

Application to Cultivate Industrial hemp as part of the North Carolina Industrial Hemp Research Pilot Program

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1. Name
Residence Address
Mailing Address (if different)
Business Address
RESEARCH PURPOSE

Check only the boxes below that correspond with the Authorized Research Purpose (established by G.S. 106-568.) of your intended planting. This section applies to all intended planting of fields or greenhouses. You will be required to provide an acceptable report of the results of your planting for each of the purposes selected before the following year’s license would be issued. Only one purpose is required and additional purposes may be subject to additional documentation at the request of the Industrial Hemp Commission.

Please attest to the following statement:

INTENDED PLANTING INFORMATION
A licensee must pay a $250 initial fee in addition to an annual fee of $250 for less than 50 acres or $500 for more than 50 acres, as well as a $2/acre or $2/1,000 square foot of greenhouse fee.

Intended Varieties
Variety Name Origin Certifying Agency Certification Type
Please note: We can only accept upload of PDF files no larger than 8 megabytes at this time.

Please attest to the following statement:

INTENDED MARKET
(for "Research With Intent to Market" application only)




Intended Purchaser(s)
Name Address City State Zip
BONA FIDE FARM CERTIFICATION
Please note: We can only accept upload of PDF files no larger than 8 megabytes at this time.
STORAGE OF HARVESTED PLANT PARTS

READ AND SIGN BELOW
ACCESS FOR SAMPLING
AGREEMENT TO MONITOR AND DESTROY VOLUNTEER HEMP PLANTS
AGREEMENT TO MAINTAIN RECORDS
AGREEMENT TO NOTIFY PLANT INDUSTRY

DISCLOSURE OF CRIMINAL CONVICTIONS

Pursuant to N.C. Gen. Stat. § 106-568.56) and N.C. Gen. Stat.§ 106-568.57, providing the Commission with false or misleading information subjects an applicant to civil and/or criminal penalties. Participation in the North Carolina Industrial Hemp program does not authorize or enable participants to violate United States DEA or other federal rules and regulations.



ACKNOWLEDGEMENT