Marijuana Supplier Application
Certificate of Registration
Marijuana suppliers doing business with an RSIC marijuana business (Three Nations Cannabis/Management) must register with the CEA Compliance Department. Complete every section below, attach the required documents, and sign electronically at the end. Submit only one application per Nevada State Business License — if multiple METRC / Cannabis Compliance Board facility licenses fall under the same Nevada State Business License, list each one in Section 1 instead of filing a separate application. Questions: (775) 420-6010 or compliance@colonyenterpriseauthority.org.
Please fix the following before submitting:

    1. Business Information

    As it should appear on the Certificate of Registration.
    Business name is required.
      Add at least one fictitious name / DBA, or select "None / Same as Business Name".
      Entity type is required.
      Physical street address is required.
      City is required.
      State is required.
      ZIP code is required.
      Select at least one facility license type.
        Add at least one state facility ID with its CCB license number, issued date, and expiration date.
        NV
        Nevada State Business License number, issued date, and expiration date are all required.

        Tribal Entities

        2. Personal Contact Information

        Must be a Key Participant acting on behalf of the business entity (an officer, general partner, or managing director).
        Contact name is required.
        Contact title is required.
        Enter a valid phone number, e.g. (775) 555-0100.
        Enter a valid email address (e.g. name@example.com).
        Agent Card Number and expiration date are required (or check the box above if applicant is a tribal entity without one).

        3. Required Documents

        Accepted formats: PDF, JPG, PNG. The cultivation/production license and Other documents accept multiple files; the Nevada State Business License and Compact/Agreement accept one file each.
        Click to choose files
        Nevada Adult-Use Cultivation License or Adult Use Production License · multiple files allowed
          Click to choose a file
          Issued by the Nevada Secretary of State · one file
            Click to choose files
            Optional · multiple files allowed · each requires a description
              Add a description for each "Other" document.

              4. Fee and Payment

              Application fee $145.00
              Cash payments are not accepted.
              Select a payment method.

              5. Certification and Signature

              I, the undersigned, hereby certify the information given above and attached hereto is true and correct and that falsification of fact will result in denial of the application or suspension/revocation of the Marijuana Supplier Certificate of Registration. I understand that all application information is a matter of Department record.
              Date of signature:
              A signature is required.

              Application submitted

              Thank you — your Marijuana Supplier Application has been received. A confirmation copy has been emailed to the address you provided. The Department will act on your application within fifteen (15) days of receipt.