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2. Business Name & DBA:*
4. County Permit Number (or State License Number):*
6. Business Type (select all that apply):

   1. Nursery
   2. Retail - Storefront
   3. Retail - Non-Storefront
   4. Manufacturing
   5. Delivery
   6. Distribution

   Please note: Cultivation is not taxed on Gross Receipts or on a quarterly basis. Please refer to our Handbook for more information.

8. Business Physical Address:*
10. Quarterly Reporting Period:*
    -- Select One --Quarter 1 (Jul - Sep) due Oct 31Quarter 2 (Oct - Dec) due Jan 31Quarter 3 (Jan - Mar) due Apr 30Quarter 4 (Apr - Jun) due Jul 31
12. Quarterly Tax Return Due Date:*
    Quarterly Tax Return Due Date:
14. Date Submitted:*
    Date Submitted:
16. Number of Months Late:*
18. Gross Receipts (total amount received this quarter):*
20. SUBTOTAL - TAX DUE (2.81% of Gross Receipts):*

    Please Note: For Quarterly Tax Returns for Fiscal Year 24/25, use the prior tax rate of 2.73%.

22. Penalty 1 (10% of Tax Due if late):*
24. Penalty 2 (additional 10% of Tax Due if more than 1 month late):*
26. Interest (1.5% of Tax Due if late, if more than 1 month late 1.5% on Tax Due and Penalties):*
28. TOTAL TAX, PENALTIES & INTEREST DUE:*
29. Pay Online:
    Pay cannabis taxes
31. Full Name:*
33. Phone Number:*
35. Primary Business Email Address:
37. Additional Business Email Address:
39. Upload METRC Data (required):
41. Upload additional METRC Data:
43. Upload additional METRC Data:
45. Upload additional METRC Data:
47. Upload additional METRC Data:
49. METRC Data unavailable:

    1. By checking this box, you are confirming that you are not able to provide METRC Data because you do not have access to the METRC system yet.
51. Confirmation:*

    1. I declare under penalty of perjury that the information contained in this form is true and correct and that I am signing as an authorized agent of the business listed on this form.

    I understand that storage of contact information, including but not limited to names, telephone numbers, and email addresses in the TTC's request database may constitute a public record which may be subject to disclosure under the California Public Records Act, Government Code Section 6250.

Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field