APPLICATION FOR PRIVATE HIRE _ HACKNEY CARRIAGE DRIVER'S DUAL LICENCE

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APPLICATION FOR PRIVATE HIRE _ HACKNEY CARRIAGE DRIVER'S DUAL LICENCE Powered By Docstoc
					            APPLICATION FOR THE RENEWAL OF A HACKNEY CARRIAGE VEHICLE LICENCE

                     Please read the Criteria for Hackney Carriage Vehicle Licence below
                                      BEFORE you completed this form.
                                                                                    For Office Use Only

Surname ____________________________________________________
                                                                                 Date Received ______________________
Forenames __________________________________________________
                                                                                 Fee _______________________________
Address _____________________________________________________
                                                                                 Receipt No. ________________________
         _____________________________________________________
                                                                                 App. Complete _____________________
Postcode ____________________________________________________
                                                                                 Date Issued _ _______________________
Phone No. ___________________________________________________
                                                                                 HC No. ___________________________
Name and address of any other party involved with this vehicle*

Name ______________________________________                 Nature of Interest _____________________________

Address ____________________________________

         ____________________________________

Postcode ___________________________________                Date of Birth _________________________________

*Continue on separate page if required.

How many Hackney Carriage Vehicle Licences do you hold? _________________________________________

Have you ever been convicted in Court?          Yes/No*
*Delete as appropriate

Give details of all convictions, motoring or otherwise

         OFFENCE                        COURT                         DATE                       PENALTY




Please give full details of vehicle for which you propose to apply for renewal

   Plate No.        Reg. No.        Make and          Date first       Cubic          Seating         Colour
                                     Model           Registered       Capacity        Capacity




In accordance with the provisions of the Town Police Clauses Act 1847 and the Local Government
(Miscellaneous Provisions) Act 1976. I/we make application to the Council to licence the above vehicle as a
Hackney Carriage Vehicle to be used within the Borough of Castle Point.
Note: Renewal application will not be accepted without the production of the following:-

 Current Insurance Certificate        ( )                  MOT Certificate (if applicable)        ( )


 Vehicle Registration Document        ( )                  Mechanical Inspection Certificate      ( )


 Fee £


IF ANY PERSON KNOWINGLY OR RECKLESSLY MAKES A FALSE STATEMENT OR OMITS ANY
MATERIAL PARTICULAR IN GIVING INFORMATION UNDER THIS SECTION, SHALL BE GUILTY OF AN
OFFENCE

Signed: _____________________________________              Dated: ______________________________________

All joint proprietors to sign: ____________________________________________________________________

Licences expire annually. Licensees are reminded that it is an offence to drive or employ a driver, at any time,
who does not hold a current Dual Hackney Carriage/Private Hire Driver’s Licence issued by the Council. A
separate application must be made in respect of such licences.

If your application is approved and all of the Council’s requirements are met you will be issued with a licence. The
Council’s Licences are issued subject to conditions which you must read carefully (these are set out in the
Council’s policy document which can be obtained from the Licensing Unit).

Please complete and return the application form to:        Castle Poing Borough Council
                                                           LICENSING UNIT
                                                           Council Offices
                                                           Kiln Road,
                                                           Benfleet
                                                           Essex
                                                           SS7 1TF

The information supplied on this form will be held on computer Castle Point Borough Council may use this
inforamtion to check other information supplied to you to the Council. The Council may from time to time disclose
some of this information in accordance with the Data Protection Act 1984.
If you would like a copy of this document in large print, audio tape, Braille, a different format or
language please contact the Licensing Unit 01268 882416.

If you would like a copy of this document in large print, audio tape, Braille, a different format or
language please contact the Licensing Unit 01268 882416.