Product types (tick all that apply):
• Raw Flower (THC/CBD)
• Extracts/Oils
• Finished Products (capsules/sprays/gummies/tinctures)
• Other

Certificates of Analysis (per batch):
• External ISO/GLP-accredited lab
• Internal lab only
• No

(Attach recent CoAs and list of contracted labs.)

Stability data available (long-term/accelerated) for finished products/extracts:
• Yes
• No

QMS in place:
• ISO-certified
• Internal documented SOPs
• None

SDS/MSDS available for relevant materials (solvents/extracts/etc.):
• Yes
• No (attach)

Validated secure storage:
• On-site
• Third-party
• No

Temperature ranges supported:
• 2–8°C
• 15–25°C
• Other

Temperature monitoring/data-loggers:
• Yes
• No

Export logistics capability (customs clearance for medical cannabis/CDs):
• Regular
• Occasional
• No

Traceability (seed-to-sale/batch tracking):
• Electronic system
• Paper-based
• None

Recall readiness & 24/7 contact in place:
• Yes (contact)
• No

Recall history in last 3 years:
• Yes (details)
• No

Acceptance of audit rights (remote/on-site) by Intaleaf/Nompharma:
• Yes
• No

Any director/UBO convictions (drug/financial/regulatory)?
• Yes (details)
• No

Compliance with AML regulations in your jurisdiction:
• Yes
• No

Sanctions/PEP screening performed on directors/UBOs:
• Yes
• No

Declaration

I/we confirm the information provided is true, complete and accurate and that all required documents are attached.

Required Supporting Documents (attach)