Pre-Authorized Debit Form

Form ID: 258
Last updated: March 25, 2024
PDF | 256.15KB | 2 pages

Document details

Cannabis Retail Store Pre-Authorized Debit Form.

Complete this form if you want to set up pre-authorized debit payments to AGLC.

How to submit

To apply online:

Online Licensing Portal

For more information, visit Online Licensing.

Note: Applications may be filled out manually until June 21, 2024, after which time all cannabis licence applications will be submitted through the online licensing portal. You may mail the completed document to:

Alberta Gaming, Liquor and Cannabis
Regulatory Services Division
50 Corriveau Avenue
St. Albert, AB T8N 3T5
Email: cannabis.licensing@aglc.ca

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