LIC-4018-FORM Successor In Interest Form {LIC-4018-FORM}

LIC-4018-FORM - SOCIAL EQUITY SUCCESSOR-IN-INTEREST DESIGNATION FORM. This form is for Applicants or Licensees to designate the successor(s)-in-interest of their Equity Share of the Social Equity Applicant (business entity) on file with the Department of Cannabis Regulation (DCR). Los Angeles Municipal Code (LAMC) section 104.20(a) (2)(ii)(4) requires that a Social Equity Individual Applicant identify a natural person(s) as their own successor-in-interest or assignee. This form does not replace the requirement to include designated successor-in-interest language on all corporate documents subject to Equity Share review under LAMC section 104.20. Please note: This form is for DCR’s record-keeping purposes only. This form, on its own, may not meet the legal requirements to be a testamentary document (e.g., a will or trust), or to amend or supplement a testamentary document that has already been or may in the future be executed by a Social Equity Individual Applicant. Thus, DCR recommends Applicants and Licensees to seek independent legal advice to ensure the person(s) designated on this form as the successor-in-interest will be legally entitled to inherit the Equity Share of a Social Equity Individual Applicant. Please note that a License may be subject to denial or revocation if the designated successor-in-interest of the deceased Social Equity Individual Applicant does not inherit the deceased’s interest in the Social Equity Applicant or Licensee. www.FormsWorkflow.com