1

Name of Registrant:  

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Name of Registrant:

2

Address Where the Grow Will Occur:  

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Address Where the Grow Will Occur:

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I certify under penalty of perjury under the laws of the state of California that:

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I certify under penalty of perjury under the laws of the state of California that:

I am 21 years or older.

This grow is for personal use only, or for use by others residing with me ages 21 or older. I will not provide marijuana to a minor or aid or abet anyone else in doing so.

The grow area will not exceed 32 square feet, and will be limited to six or fewer plants.

The address included above is my personal residence.

I am a lawful owner of the residence or have obtained written permission from my landlord to cultivate marijuana.

I understand it is my responsibility to obtain information about the requirements of indoor marijuana cultivation in the unincorporated area of Kings County, and intend to comply with those requirements.

I am hereby advised that marijuana remains a Schedule I substance under the federal Controlled Substances Act.

Click here for a copy of Kings County Ordinance No. 677.

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2. Email Address

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