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(2) The name, maililig address, and telephone Lium <br />(3) The cooperative or collective name and street a ber of the applicant, <br />ddress for which registration is sought <br />, as <br />well as any other names under which the collec . <br />tive ocooperative may operate, <br />(4) Copies of the collective or cooperative's entity- formation document such ass, without <br />li i , its Articles of Incorporation, Articles of A <br />Membership Agr m n , etcetera. <br />(5) A one-page description of the collective or coo ssociation, Lye operati g or <br /> <br />perative's nature and its plans for security <br />and non-diversion of medical cannabis. <br />(A) Complete legal name, and a alias(es): <br />(S) Some form of dated documentary evidence that the collective or cooperative had begun <br />operating at the location prior t December 31, 2011, including but not limited to, a lease. <br />a utility receipt, a State Board of Equalization Seller's Permit, or a Federal Employer <br />Identification Number. <br />65A-41