Application for a Taxi/Private Car Licence (new or renewal)

Is this a new application or a renewal

New Application

Renewal

Is the applicant an individual?

Yes

1. This section to be completed where the applicant is an individual

Full Name

Title

First Name(s)

Surname

Home Address

Address

Address 2

City/Town

Post Code

E-mail

Home Telephone

Mobile

Date of Birth

Place of Birth

2. To be completed where the applicant is a partnership, firm or limited company

Trading Name of Business

Business Address

Address

Address 2

City/Town

Post Code

E-mail

Business Telephone Number

Business Mobile number

3. Details of all partners / directors in business

Please provide details of all partners / directors involved in your firm, please note where there are more than 3 partners / directors, please complete their details to include full name, home address, date of birth and telephone number as a word or text document and upload it where indicated.

Details of partner 1

Full Name

Title

First Name(s)

Surname

Home Address

Address

Address 2

City/Town

Post Code

E-mail

Home Telephone

Mobile

Date of Birth

Place of Birth

Details of partner 2

Full Name

Title

First Name(s)

Surname

Home Address

Address

Address 2

City/Town

Post Code

E-mail

Home Telephone

Mobile

Date of Birth

Place of Birth

Details of partner 3

Full Name

Title

First Name(s)

Surname

Home Address

Address

Address 2

City/Town

Post Code

E-mail

Home Telephone

Mobile

Date of Birth

Place of Birth

Please upload details of any other partners

One file only.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.

4. Day to day running / managing of the business activity

Full name

Title

First Name(s)

Surname

If this person is not one of those named above please also give the following information.

Manager Address

Address

Address 2

City/Town

Post Code

E-mail

Home Telephone

Mobile

Date of Birth

Place of Birth

5. Criminal Convictions

Criminal Convictions

Subject to the provisions of the Rehabilitation of Offenders Act 1974, has any party named above been convicted of any crime or offence in any Court in the United Kingdom?

Yes

Conviction 1

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

Conviction 2

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

Conviction 3

Name

Date of Conviction

Convicting Court

Details of Offence

Sentence

6. Other Licences

Has, or do, any of the parties named above previously held, or currently hold, any type of Local Authority Licence?

Yes

Other Licence Application

Other Licence 1

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Other Licence 2

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Other Licence 3

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Has any of the parties named above, ever applied for any type of Local Authority Licence/s and had their application refused?

Yes

Other Licence Refusal

Licence Refusal 1

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Reason for Refusal

Licence Refusal 2

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Reason for Refusal

Licence Refusal 3

Name

Type of Licence

Date Granted

Expiry Date

Issuing Authority

Reason for Refusal

7. Fitness to Work

Does any party directly involved in the day to day licensed activity suffer from, or have any disability, allergy or other condition likely to affect their fitness to operate?

Yes

Person 1

Name

Nature of Condition

Person 2

Name

Nature of Condition

Person 3

Name

Nature of Condition

8. Vehicle Storage and operation

Address of premises where vehicle is to be kept

Address

Address 2

City/Town

Post Code

Address of premises from which vehicle will be operated

Address

Address 2

City/Town

Post Code

9. Vehicle Details

Registration Number of Vehicle to be Licensed

Date Vehicle First Registered

Vehicle Model

Make of Vehicle

Number of Doors

Description of Vehicle

Colour

Chassis Number

Number of Passengers

Width Across Back Seat

Insurance Cover Expiry Date

MOT Documents

Maximum 4 files.
10 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.

MOT Expiry Date

Insurance Documents

Maximum 4 files.
8 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, rtf, pdf, doc, docx, xls, xlsx.

Date Vehicle Last Inspected

Inspecting Mechanic

Address

Address 2

City/Town

Post Code

Days on which the vehicle will be available for Hire

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Times when the Vehicle will be available for hire

Is the vehicle wheelchair accessible?

Yes

10. Declaration and Information

I declare that the particulars given by me on this form are true and I hereby make application to ��Ů�� for the grant of the licence applied for above. I understand that I, or any person who, in connection with the making of this application makes any statement which I/they know to be false or recklessly makes any statement which is false in a material particular shall be guilty of an offence and liable, on summary conviction, to a fine not exceeding £2500.00.

I also confirm that, if granted a licence, I will comply fully with the conditions of that licence and have, previous to lodging this application, made myself familiar with the terms of ��Ů��s’ standard conditions pertaining to the licence.

Notes:

Any form lodged which has not been fully completed will be considered incompetent and returned to the applicant.
Please note that the Council may consider the application at a public meeting if there is a valid objection/representation made to the granting of a licence. A hearing of the PPSL Committee will be heard to determine whether the licence should be granted. If there is to be a hearing the applicant will be notified and will be invited to attend.

Supporting Documentation:

The following supporting documentation along with the appropriate fee MUST be lodged with the form otherwise the application will be considered incompetent and returned:

The correct fee
Valid Insurance policy
A certificate of compliance in relation to Notice of Posting see Section 8

The information you have supplied on this form will be used for the purpose for which you have provided it, and appropriate measures are in place to protect your personal data. A full privacy notice, which provides information about your rights under current data protection legislation and details about what will happen to your personal data can be found here:

Privacy Notice - Civic Government Licenses

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