NY's Justice Involved Program - Canna Business Services

1) Were you CONVICTED of a cannabis offense?

Yes
No

Approximately what date were you CONVICTED (not arrested)?

In what state was your arrest made?

In what state were you a resident in at the time of this arrest?

Were you ARRESTED, but not convicted of a cannabis offense?

Yes
No

Approximately what date were you arrested?

In what state was your arrest made?

In what state were you a resident in at the time of the arrest?

2) Do you have a parent, legal guardian, child, spouse, or dependent who was CONVICTED of a cannabis-related offense? Or are you the dependent of an individual who was CONVICTED of a cannabis-related offense?

Yes
No

What state was that individual arrested?

Approximately what date was the arrest?

What was that individual’s residence (home state) at the time of the arrest?

What is the relationship of this person to you? (e.g. cousin, sibling, parent, guardian, child)

3) Would you be able to show the State evidence that the individual with the conviction lived in New York at the time (through utility bills, lease with the individual’s name and an address in NY, etc.)?

Yes
No

4) Are you a business owner?

Yes
No

How much ownership do you have in the business? (e.g. 100% owner, 5% owner, etc.)

What is your position in the business? (e.g. President, COO, etc.)

Is the business a for-profit or a non-profit?

For-profit
Non-profit

How many years has the entity been in business?

Has the business been profitable for at least 2 years? (i.e. you made a profit for at least 2 years)

Yes
No

How many years has it been profitable? (does not need to be consecutive years)

Have you filed your taxes for the business throughout the years?

Yes
No

What is the business name?

How many years has the nonprofit been in business?

Is it filed with the IRS as a 501(c)(3)?

What is the focus of your nonprofit?

What communities do you primarily serve?

What is your nonprofit’s name?

What is your nonprofit’s website?

How many years has it been profitable? (does not need to be consecutive years)

Have you filed your taxes for the business throughout the years?

Do you PRIMARILY serve individuals that have had cannabis arrests? (i.e. this is the primary focus of your nonprofit)

Do you have board members / officers?

Yes
No

Have any of them been convicted of a cannabis offense?

Yes
No

Are any of them related to an individual convicted of a cannabis offense?

Yes
No

How many employees do you have?

5) Are you a member of a diverse population? (e.g. female, minority, veteran, disabled)

Yes
No

List your diverse status (e.g. female, minority, veteran, disabled)

6) Anything else you would like us to know?

7) Thank you for your submission! We will score your quiz and let you know ASAP if we believe that you qualify! In order to send you the results, we need the following information:

Name*

First Last

*partial names or initials provided will not be graded

Business Name

Phone Number*

Email Address*

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