Cook County Cannabis Development Grant

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Document Upload

This form is a supplemental document upload form for applicants who have more than 10 documents to submit with their application. Please note this form is also limited to only 10 documents.


If you have more than 10 documents to submit, please resubmit this form as many times as needed.


For additional information, visit our webpage cookcountyil.gov/service/cannabis to review the Getting Started Guide for further descriptions of the required documents.


Please also review the FAQs for more detailed information about the Program.


If you need assistance or have questions about the CCC Development Grant required documents, please reach out to cannabis.oed@cookcountyil.gov.

This must match the name of your business as listed on your initial application

This number must match the EIN above and provided on your application

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This number must match the EIN above and provided on your application

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Select which license these documents are relevant to:*

Please choose one.

If you have more than one type of license that you filled out an application for, you must submit a separate "Document Upload" form for each license type.

Please upload the following documents. Kindly ensure that the copies include the complete display of key pieces of information, including your EIN, business name, relevant dates, etc.


a. Please upload a copy of a current form of photo identification (not expired) for the business owner who is submitting the application.

Acceptable documents are:

  • Driver’s license
  • Permanent resident card
  • REAL ID
  • State ID
  • US Passport


b. Please upload evidence that your business is in good standing with the State of Illinois.

This can be a Certificate of Good Standing purchased from the Illinois Secretary of State, or a screen shot of the file detail for your business, accessed on from the Illinois Secretary of State website.


c. Please upload a complete copy of the filed 2022 or 2023 federal tax return for your cannabis-based business (e.g., Form 1040 with Schedule C, Form 1065, or Form 1120).

Include all pages of the return and all schedules and attachments, such as K-1s, to document ownership of the business entity.


d. Bank Account Information


Please upload a statement for your business bank account, dated within the last three (3) months (February, March or April of 2024).


Cook County recommends that each applicant have a bank account with a financial institution that has authorized the account in question to be used with for their cannabis-based business.


If a CCC Social Equity Grant is awarded and the awardee has a non-cannabis bank account (i.e., an account with a financial institution that has not expressly consented to using that account for cannabis‐related activities), the awardee will be solely responsible for any impairment or loss of the grant proceeds resulting from that financial institution freezing the grant funds or the bank account or taking other legal compliance‐related action.


Please ensure that the business name, business address and name of the financial institution where the account is located are clearly visible. The name on the business account must match the business name on the uploaded federal tax return.


e. Please upload a copy of your valid cannabis license, issued under the State of Illinois Adult-Use Cannabis Social Equity Program.


Please make sure that all important information is clearly visible. This includes the name of the licensee, license number, issue or effective date, expiration date, facility location (if applicable) and BLS region number (dispensaries only).


f. Please upload a completed and signed Consent for Disclosure form, authorizing the appropriate State licensing agency to verify information you submit in your grant application.

Only one (1) Consent for Disclosure form is required to be provided on behalf of your business. Please ensure that the form is signed by a Principal Officer of the business that holds the cannabis license and include the badge number of that Principal Officer, if applicable.


Dispensary license holders must use the IDFPR Consent for Disclosure form [IDFPR form].


Craft grower, infuser and transporter license holders must use the IDOA Consent for Disclosure form [IDOA form].


g. Please upload documentation confirming the current place of primary residence for each business owner, including yourself.


Acceptable documentation for each business owner is one item each from List A and from List B.


List A (submit one for each business owner)


Please upload a copy of a valid form of photo identification for each business owner. Include the business owner’s last name in the file name (e.g., Jones_license, USPassport_Smith).

Acceptable documents are:

  • Driver’s license
  • Permanent resident card
  • REAL ID
  • State ID
  • US Passport


List B (submit one for each business owner)


Please upload a copy of one of the following documents to verify the current residential address of each business owner. Include the business owner’s last name in the uploaded file name (e.g., Jones_bank statement, Mortgage_Smith).


Documents must be dated within the past 3 months (February, March or April of 2024) and include the business owner’s name on the document:

  • Bank statement;
  • Credit card statement;
  • Mortgage statement;
  • Residential lease (must be current / unexpired); or
  • Utility bill.


h. ONLY if you indicated in Section 3 that you have applied to the Illinois Department of Agriculture or IDFPR to extend your license expiration date, please upload a copy of your application for extension.


i. ONLY if you indicated in Section 3 that you have identified and committed to an operating location, please upload documentation confirming that your business does or will operate in Cook County, at the address that you provided in Section 3. Acceptable forms of documentation are:

  • Lease/deed for the business site; or
  • Letter of Intent (LOI) for the proposed business site; or
  • Purchase agreement for business site.
Drag and drop files here or

You can also use the space below to add any information or comments regarding the document uploaded.

If you have more than 10 documents to submit, you may submit this form as many times as needed.

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