Key Points NATIONAL INSURANCE CARD IF YOU CANNOT PROVIDE ABOVE DOCUMENTS, PLEASE PROVIDE 2 OF THE FOLLOWING:

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1 HACKNEY CARRIAGE & PRIVATE HIRE NEW APPLICATION Key Points Current Fees from 01/04/2008 Question 18 must be endorsed. Private Hire This must be done using the operator s stamp. Hackney Carriage it must be the signature of the vehicle proprietor. DVLA mandate form must be completed. Please tick the box relating to Wolverhampton City Council and complete full name and address details. Please provide the following ORIGINAL documentation: DRIVING LICENCE HELD FOR AT LEAST 12 MONTHS (If you have a photo card licence, must provide both parts) 118 or 26 1 st J.S.A. payment 3 x J.S.A. = 78 TOTAL PASSPORT P45/P60 CERTIFICATE MARRIAGE CERTIFICATE NATIONAL INSURANCE CARD WAGE SLIP BIRTH CERTIFICATE IF YOU CANNOT PROVIDE ABOVE DOCUMENTS, PLEASE PROVIDE 2 OF THE FOLLOWING: BANK STATEMENT STORE CARD STATEMENT TV LICENCE VEHICLE REGISTRATION CERTIFICATE UTILITY BILL CREDIT CARD STATEMENT MEDICAL CARD FINANCIAL STATEMENT Four colour identical passport photographs will also be required. Do not complete medical until instructed to do so. CRB Form 1. Complete section B as follows, declare the position as applicable to your application: B Details of position for which Disclosure is being requested 13 Position P R I V A T E H I R E / H A C K N E Y D R I V E R 14 Organisation W O L V E R H A M P T O N C I T Y C O U N C I L 15 Address R E G U L A T O R Y S E R V I C E S 16 L I C E N S I N G C I V I C C E N T R E 17 Town/City W O L V E R H A M P T O N 18 County W E S T M I D L A N D S 19 Post Code W V 1 1 D A 2. Please do not complete sections E and F. 3. Leave back of form blank and remember to only use BLACK ink.

2 A P P L I C A T I O N F O R A H A C K N E Y C A R R I A G E V E H I C L E L I C E N C E WOLVERHAMPTON CITY COUNCIL REGULATORY SERVICES, LICENSING SERVICES CIVIC CENTRE ST. PETER S SQUARE WOLVERHAMPTON WV1 1DA Telephone (01902) Direct Line (01902) Telex: WOLMBC G Facsimile: (01902) PLEASE ANSWER EVERY QUESTION (Abbreviations are not acceptable) NEW/RENEWAL H.V..... PLEASE WRITE IN CAPITALS AND IN 1 DETAILS OF APPLICANT (WHO SHOULD BE THE PROPRIETOR OF THE VEHICLE) * Delete as necessary Mr / Mrs / Miss / Ms* Surname:... Christian/Forenames:... Maiden Name:... Present Residential Address:......Post Code... Date of Birth DAY MONTH YEAR INK Telephone : Home:... Business:... Mobile: DETAILS OF VEHICLE Please set out below details of the vehicle which you wish to licence as a Hackney Carriage Vehicle:- (Please note vehicles must be type approved eg. FX4s, Metro Cabs, TX1, TX2, TX4, Fiat Scudo and Peugeot E7, Mercedes Vito, LC7 Citroen, LC7 Peugeot, TW200, Mercedes Executive Taxi, VW City 7, Nissan NX8, Fiat XL7, Mercedes VITO MX7, Citroen Sentinal) Registration Number: Make of Vehicle: Model: Colour: Engine Size: Chassis Number: Passenger Seating Capacity: Year of Registration: Engine Number: Fare Meter Number:

3 Fare Meter Make: Type of Meter: (ie, manual or calendar) 3 Where is the vehicle to be based when not in use?... 4 DETAILS OF ROAD TAX LICENCE Please set out below details of the current vehicle excise licence: Licence Number:... Date of Issue:... Expiry Date:... Amount of Duty Paid:... 5 (a) INTENDED DRIVER(S) OF VEHICLE If this application is approved, will you, as licence holder, drive the vehicle? (b) If the answer to question 5(a) is YES, are you currently licensed by the council as a Hackney Carriage driver? (c) (d) If the answer to question 5(b) is YES, please state your Hackney Carriage driver s licence number below: Are you currently suspended as a driver by Wolverhampton City Council? 6 Please state below the name and address of the person, proprietor or firm who will operate the vehicle. Name: Address:.. Post Code: 7 DECLARATION I declare that the replies given by me on this form are true, complete and accurate. I understand that if any information given by me is false, I shall be liable to prosecution and that any licence obtained as a result may be revoked. Dated: Signed: 2

4 8 PROPRIETORSHIP REQUISITION Section 40 Town Police Clauses Act 1847 Section 48 of the Local Government (Miscellaneous Provisions) Act 1976 I. of (residential address)..... hereby declare that I am a Proprietor of the vehicle registration number.... more fully described in the application of (date)... for a Hackney Carriage Vehicle Licence and that the following are the names and surnames and addresses of the applicant herein and of every Proprietor or part Proprietor of such vehicle, or person concerned, either solely or in partnership with any other person, in the keeping, employing or hiring of such vehicle. This also includes any limited company. This information is true to the best of my knowledge and belief. Full Name Address State nature of interest (Proprietor and/or Partner and/or Driver 3 Signed: (Applicant) Date: Applicants are advised that to make, knowingly or recklessly, a false statement or omit any information from this application is a criminal offence. 9 IMPORTANT CHECKLIST After you have filled in this form, tick box to show that you have enclosed: The Fee (CHEQUES SHOULD BE MADE PAYABLE TO WOLVERHAMPTON CITY COUNCIL WCC) Vehicle Insurance Details Vehicle Registration Details M.O.T. Certificate (if appropriate) Proprietorship Requisition PLEASE NOTE ALL DOCUMENTS MUST BE ORIGINALS APPLICATION FEES WILL NOT BE REFUNDED PLEASE NOTE THAT FOR NEW VEHICLE LICENCES FROM THE DATE OF SUBMITTING THIS APPLICATION IT MAY TAKE UP TO 20 WORKING DAYS FOR AN APPOINTMENT TO BECOME AVAILABLE AT CULWELL STREET GARAGE THE INFORMATION GIVEN MAY BE HELD IN MANUAL OR COMPUTERISED FORM AND WILL BE SUBJECT TO THE PROVISIONS OF THE DATA PROTECTION ACT 1998 This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes. For further information, see FOR OFFICIAL USE ONLY Date Received: Amount: Method of Payment: Cash Cheque Cheque Initials: Receipt : Receipt Issued By:

5 WOLVERHAMPTON CITY COUNCIL HACKNEY CARRIAGE AND PRIVATE HIRE VEHICLE INSPECTION TEST The vehicle should be presented to the Council s Inspection Centre at Culwell Street in showroom condition and the information below is to assist the owner. 1. The mechanical test is based on the Ministry of Transport test carried out pursuant to Section 45 of the Road Traffic Act 1988, but it is advisable for the vehicle to be prepared for the inspection by a qualified vehicle technician before presenting the vehicle to the Inspection Centre. 2. All internal fittings and fixtures ie. carpets, seats, trims and seat covers should be clean and in good condition. Rips/tears in seat and broken trims should be replaced or repaired to a high standard before submitting the vehicle for inspection. 3. All external fitting ie. wheel caps/discs, bumpers and trims should be fitted, clean and in good condition. Rusty/damaged metal bumpers or damaged plastic bumpers are not acceptable. 4. The paintwork should be maintained to a high gloss finish and of a uniform colour free from scratches which expose the under primer or metal. It is advisable that if any paintwork is undertaken on the vehicle that it is done by a reputable garage to a high standard. 5. The body panels should be free of dents and all body panels should fit correctly. The excessive use of body filler and repairs that are of a poor standard are not acceptable. 6. signs, notices, advertisements, plates, marks, numbers, letters, figures, symbols, emblems or devices whatsoever shall be displayed on, in, or from the vehicle except as may be required by any statutory provision (including bye-laws). This includes the display of unauthorised transfers/stickers to the body or windows of the vehicle. 7. The fire extinguisher and first aid kit must be maintained in good condition.