Application For An Authority To Drive - Taxi-Cab Or Private Hire Vehicle Page 4
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9Application for an Authority to Drive,
Taxi-Cab or Private Hire Vehicle
ii
Date
25.
Do you have any criminal convictions in NSW or
elsewhere which occurred more than ten (10) years ago
/
/
(more than three (3) years ago if committed as a
day
month
year
juvenile) where you were imprisoned for more than 6
Details of offence
months or the conviction/s related to a sexual offence?
This question requires you to provide details of any convictions
which occurred more than ten (10) years ago in which you were
imprisoned for more than 6 months or where the conviction related
to a sexual offence. You must provide details of any sexual offence
you have been convicted of even if the sentence was less than 6
Court
months or where no sentence was served.
Yes
if yes give details
No
Outcome
i
Date
/
/
day
month
year
Details of offence
iii
Date
/
/
day
month
year
Details of offence
Court
Outcome
Court
Outcome
ii
Date
/
/
day
month
year
Details of offence
iv
Date
/
/
day
month
year
Details of offence
Court
Outcome
Court
Outcome
iii
Date
/
/
day
month
year
Details of offence
Please attach a separate sheet if you require more space
Court
Outcome
Please attach a separate sheet if you require more space
Catalogue No. 45071750 Form No. 1688 (03/2014) ABN 76 236 371 088
Page 4 of 8
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