Transfer Of Vehicle Ownership Application Form (Page 3 of 4) in pdf

PRIVATE HIRE OPERATOR INFORMATION

29. Name of the operator(s) you will be using the vehicle to fulfil bookings for?

Name:

Address:

Name:

Address:

Name:

Address:

DECLARATION

Fraud Act 2006

I hereby declare that I fully understand, have read and checked the details and questions on

this application form and that the foregoing statements are true. I understand that it is a

criminal offence if I or anyone else gives false information, or makes a false representation, or

fails to disclose information in order for me to obtain a private hire vehicle licence. I am fully

aware that the provision of a false statement, or information, or the concealment of offences/

convictions/ cautions in order to obtain a licence is an offence under the above Act which may

result in the refusal of this licence application and any subsequent licence applications for a

period of one to three years. I am also aware that any licence granted as a result of breaching

this Act will be immediately revoked.

I have received and read the private hire conditions for operators, vehicles and drivers and I

undertake, in the event of a licence being granted, to observe and perform such conditions.

Signed by or on behalf of the applicant*

Signed ........................................................

Date......................................................

Print Name.....................................................................Capacity................................................

Signed ........................................................

Date......................................................

Print Name.....................................................................Capacity................................................

* If signing for a Ltd Company or LLP only one signatory is required, otherwise all applicants detailed on this

application form must sign above.

Signed by the current licence holder

I confirm that the above person is the new vehicle proprietor and I consent to the private hire

vehicle licence being transferred to the new vehicle proprietor.

Signed………………………………………………………Date……………………………………….

Print Name……………………………………………………………………………………………….

Please Note

Transfer Of Vehicle Ownership Application Form Page 3