East Northamptonshire Council

East Northamptonshire Council

Confidential

Please return this form to:

Licensing Administrator

Environmental Services

East Northamptonshire Council

Cedar Drive

Thrapston, Northamptonshire NN14 4LZ.

Phone: 01832742057

Fax: 01832 742192

DX: 701611 Thrapston

E-mail:

Website:

Section 48 Local Government (Miscellaneous Provisions) Act 1976

Application to licence a private hire vehicle

I am applying for a licence for the private hire vehicle detailed below

Please give the name or the owner (or every part owner) of the vehicle

Owner/Part Ownerof vehicle and detail of interest
Last name (or names):
First name (or names):
Address and postcode:
Phone number (s) :

Please bring in the following: If you do not provide everything we ask for, we will have to return your application to you.

Your application fee, please make your cheque payable to ‘East Northamptonshire Council’, the council can not accept cash payments. Please see charges and fees for amount payable.

/ 

• Vehicle registration document

/ 

• Insurance certificate and policy document

/ 

• M0T certificate (if this applies)

/ 

For our use only:

Application fee received:
Vehicle registration document photocopied
Insurance certificate and policy photocopied
MOT certificate (if this applies) photocopied
Council vehicle test:
Licence issued:
INCOME CODE: CKN0039619

Please answer the following questions.

1 / Give the name of the person who the vehicle is to be registered to (if different from the above)
Give the address of the owner of the vehicle
What is the date of birth of the owner of the vehicle
Give the place of birth of the owner of the vehicle

Please tell us about the vehicle:

2 / Make, Model and Colour of vehicle
Registration Number
Date it was first registered
Chassis number
Engine number
How many passengers can it seat
Licence Plate Number
When is the MOT test due
Is the vehicle fitted with a two-way radio? / Yes  No 

Taximeter details:

3 / Type or manufacturer’s name
Rental or service company name

Address details:

4 / Where will the vehicle be kept when it is not in use
Are there garage and parking facilities provided
Address where the vehicle will operate from

Insurance details:

5 / Insurance Certificate number
Name of the Policyholder
When does the insurance start and end / Start End
Vehicle index number
Type of cover
Insurance company/Underwriter
How is the insurance paid (for example, once a year or every three months)
What is the name and address of the Broker, if applicable and their telephone number

Licensing

6 / If the vehicle has been licensed before, what was the licence number and who was the issuing authority. / Licence number:
Issuing Authority:
Have you ever been refused a private hire vehicle licence, or has any private hire vehicle licence you have held been suspended or revoked
. / Yes  No 
Have you ever applied for and been refused a private hire driving licence.
If Yes, please give us the details / Yes  No 
Have you applied for the re-issue of a private hire driving licence and been refused.
If Yes, please give us the details / Yes  No 
Has your private hire licence been suspended or revoked.
If Yes, please give us the details / Yes  No 

Offences

7 / Please tell us about ALL offences in connection with a motor vehicle, its Licensing or Insurance, for which you have been convicted.
Please tell us about the penalties imposed and include endorsements.
(Continue on a separate piece of paper if necessary)
Please give details of all fixed Penalty Notices received
Please tell us about ALL criminal offences for which you have been convicted.
Please include any fine or sentence imposed.
(Continue on a separate piece of paper if necessary)
Please tell us about ALL Cautions you have received.
You can continue on a separate sheet, if necessary.
Have you ever received an Anti Social Behaviour Order / Yes  No 
Do you have any outstanding charges or summons that apply to you
If Yes, please give the date of the court hearing (if you know it)
(Continue on a separate piece of paper if necessary) / Yes  No 
Have you ever been convicted of any offence in relation to a company
Please give details of all convictions.
(Continue on a separate piece of paper if necessary) / Yes  No 

Declaration:

I declare that, as far as I know, the information I have given on this form is correct. I am in a position to meet all reasonable obligations to the public.
I have read and understood the conditions that apply to a licence and the byelaws concerned and will follow them.
I realise that if I make any false statement or fail to give you information that may be relevant, you may prosecute me.
Your signature:
Date:
Other owner or part owner’s signature:
Date:

Note: Please read the terms and conditions for private hire vehicles

EH/Licensing/Drivers/Driver applform 3June 2008