BOROUGH OF TAMWORTH
LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1976
APPLICATION FOR HACKNEY CARRIAGE VEHICLE LICENCE
This application must be presented by Appointment Only Monday to Friday
Please Telephone Customers Services on 01827 709 709 to make your appointment
Taxi Licensing, Assets & Environment, Tamworth Borough Council
Marmion House, Lichfield Street, Tamworth, Staffordshire
and must be accompanied by:-
a)The appropriate fee of £
b)Vehicle Registration Document
c)A valid certificate of insurance or cover note for the vehicle
IMPORTANT NOTE
It is a legal requirement that the applicant must disclose on the application form the name(s) and address(es) of any proprietor of the vehicle or any other person involved in the operation of the vehicle as a Hackney Carriage Vehicle. This would include a driver to whom the vehicle may be rented but would exclude a driver who is employed by the proprietor. It applies to any person leasing or renting the vehicle whether or not the agreement for the renting is formal and written or informal and verbal.
1)Full Name of Applicant:
Address:
Telephone Number: ------
2)Nature of Applicants Interest in Vehicle (Delete if not applicable)
IS THE VEHICLE-
Owned by YouYES/NO
(If on Hire-Purchase give name and address of hire purchase Company)
------
------
Leased to YouYES/NO
(If leased give name and address of lease-hire Company)
------
------
Rented by YouYES/NO
(If rented give name and address of proprietor of vehicle)
------
------
FOR OFFICE USE ONLYVRD / INSURANCE / PAID / RECEIPT NO / TEST DATE / ISSUED / PLATE NO
3)If there are any other persons who are concerned either solely or in partnership with any otherperson in the ownership of the vehicle or in the keeping or letting for hire of the vehicle give details, and state the nature of any persons interest. If NONE please state "NONE"
Name(s):------
Address(es): ------
------
Telephone Number: ------
4)Do you confirm that all persons or companies in Questions 3 and 4 are aware that the vehicle is to be used as a hackney carriage hire vehicle and have given their consent for such use YES/NO
5)State name and address of the hackney carriage operating base from which the vehicle will be operated.
Name: ------
Address: ------
Telephone Number: ------
6)Will the vehicle be used full or part time as a hackney carriage vehicle? FULL TIME / PART TIME
7).Where will the vehicle be kept when not is use?
------
8).Have you or any person listed in question 4 ever had a hackney carriage vehicle license refused, revoked or suspended by this or any authority ...... YES/NO
10)If the application for a vehicle to replace one already licensed by the Authority give details of the previous vehicle which is to be replaced
Registration Mark ------
Hackney Carriage Plate No ------
(delete as Appropriate)
*a)The vehicle has been sold for
- Private Use
- Part Exchanged
- will be retained in my ownership for Private use and not used as a
Hackney Carriage/Private Hire Vehicle
*b)Lease discontinued – vehicle returned to:-
Name and Address ------
*c)The vehicle will be licensed by ------Council as a Private Hire/
Hackney Carriage, Plate Number ------as from ------
*d)The vehicle has been “written off” in an accident or scrapped
*e)The vehicle and License Plate has been transferred to:
Name ------
Address ------
------
11)Is the vehicle licensed or has the vehicle ever been licensed as a Hackney Carriage or Private Hire Vehicle by any other Local Authority YES/NO
If YES give the following details
a)Name of Authority: ------
b)Date of Expiry: ------
c)Plate No: ------
DESCRIPTION OF VEHICLE
a.Registration Mark: ------
b.Make: ------
c.Model: ------
d.Colour: ------
e.Date of Registration: ------
f.Type of Body: ------PURPOSE BUILT CAB
g.Number of seats for passengers (excluding driver):------
h.Engine Capacity: ------CC
i.Type of fuel: ------DIESEL / PETROL
DECLARATION OF APPLICANT
I the undersigned declare that the information given by me in this application is correct to the best of my knowledge and belief and I understand that, if I have knowingly omitted any material particular or stated anything that I know to be untrue, I may be subject to legal proceedings and the licence which I may have been granted may be revoked or suspended.
Signed ------
Dated ------