(1) The name of the applicant. For applicants who are individuals, the applicant shall provide both the first and last name of the individual. For applicants who are business entities, the applicant shall provide the legal business name of the entity.

(2) The license number for each state cannabis license held by the applicant.

(3) The address of the location where the temporary cannabis event will be held, or if no address exists, the assessor parcel number, or street description.

(4) The name of the temporary cannabis event.

(5) A diagram of the physical layout of the temporary cannabis event. The diagram shall clearly indicate where the temporary cannabis event will be taking place on the location grounds, all entrances and exits that will be used by participants during the event, all cannabis goods consumption areas, and all areas where cannabis and cannabis products will be sold or displayed. The hours during which cannabis goods will be sold shall be noted on the diagram. The diagram shall also clearly indicate the area where cannabis waste will be stored, all areas where cannabis goods will be stored, and the specific location of each cannabis licensee and non-cannabis vendor who will be participating in the event. Each cannabis licensee and non-cannabis vendor participating in the event shall be identified with an assigned temporary cannabis event location number. The diagram shall also designate a limited-access area that can only be accessed by the cannabis event organizer and Department representatives.

(6) The dates and hours of operation for which the temporary cannabis event license is being sought. A temporary event license is required for any date in which the applicant engages in onsite cannabis goods sales or allows onsite cannabis goods consumption.

(7) Contact information for the applicant's designated primary contact person regarding the temporary event license, including the name, title, address, phone number, and email address of the individual.

(8) Contact information for a designated contact person(s) who shall be onsite at the event and reachable by telephone at all times during the event.

(9) Written approval from the local jurisdiction authorizing the applicant to engage in onsite cannabis goods sales to, and onsite consumption by, persons 21 years of age or older at the temporary cannabis event at the proposed location.

(10) A list of all licensees who will be participating in the event that provides a designated contact for each licensee who will be responsible for that licensee's activities during the event and will be available to the Department in person or by phone throughout the event, whether the licensee will be selling cannabis goods at the event, whether the licensee will be selling any non-cannabis products at the event, and a description of the type of non-cannabis products that will be sold, if applicable.

(11) A list of all non-cannabis vendors who will be participating in the event, a description of the type of product they will be selling or displaying, and contact information for a designated contact person.

(12) Attestation to the following statement: Under penalty of perjury, I hereby declare that the information contained within and submitted with this application is complete, true, and accurate. I understand that a misrepresentation of fact is cause for rejection of this application, denial of the license, or revocation of a license issued.