Application Withdrawal-License Cancellation (Cannabis Regulation) {LIC-4015-FORM}

LIC-4015-FORM - APPLICATION WITHDRAWAL / LICENSE CANCELLATION FORM. This form is for Applicants who wish to withdraw a pending application in its entirety, withdraw or cancel a particular commercial cannabis activity, or cancel a Temporary Approval or License that has already been issued. Cancellation will terminate a Temporary Approval or License. Withdrawal will terminate an application or a particular commercial cannabis activity that has not yet been issued Temporary Approval. This form contains the following sections: (A) withdrawal or cancellation request; (B) attestation form; and (C) indemnification agreement. Important: A withdrawn Application and/or canceled License cannot be reinstated and any previously paid fees will not be refunded. Submission of this form may have legal or business consequences for you depending on your prior business arrangements and individual circumstances. It is highly recommended that you seek legal advice prior to the submission of this form. www.FormsWorkflow.com