Appendix I Driver Licence application form

OFFICE USE ONLY

Amount paid

 

Receipt number

 

Date

 

 

APPLICATION FOR A HACKNEY CARRIAGE / PRIVATE HIRE / DUAL DRIVER  LICENCE

 

PLEASE READ THE QUESTIONS CAREFULLY BEFORE COMPLETING THE FORM.

PLEASE USE BLOCK CAPITALS

 

Local Authorities must protect funds they handle and so the information you have provided on this form may be used to detect and prevent fraud. The information may also be shared for the same purposes, with other organisations which handle public funds including the Audit Commission to be used as part of the National Fraud Initiative.  Your personal data will also be shared with the local authorities, which make up the Licensing Partnership, for the purpose of processing your licensing application. Your personal data will not be used for any other purpose without your prior consent, except as permitted under the Data Protection Act 1988.

 

Please state which Licensing Authority you are applying to operate within (please note one application form per authority):

Maidstone Borough Council

 

Sevenoaks District Council

 

Tunbridge Wells Borough Council

 

 

Please state which type of licence you are applying for (note that only one application per vehicle may be made per form)

Hackney Carriage

 

Private Hire

 

Dual

 

 

New application

 

Renewal application

 

Expiry date of existing licence

 

 

PART 1

GENERAL (Sole or Principal Applicant to complete in all cases)

Surname

 

Forename (s)

 

 

Any previous or other name

 

 

Current home address:                      ___________________________________________

                                                                ___________________________________________

                                                                ___________________________________________

Post code:                                             ____________________

 

All previous addresses and dates of occupancy must be provided if you have lived under 5 years at your current address.

 

 

 

 

 

 

Home telephone number:

Email address:

 

Mobile telephone number:

Fax number:

 

 

PART 2

 

DRIVER DETAILS (Applicant to complete this part if he/she wishes to drive a vehicle licensed by one of the authorities of the Licensing Partnership)

 

National Insurance number

 

Date of birth

 

 

Type of Driving Licence held

Full                                    UK                                     Other     

 

This licence has been held continuously since (enter date):______________

 

If ‘other’ what type of licence?

 

UK driving licence number: __________________________  Date of issue:___________________

 

Expiry date of licence:___________________

Have you ever been convicted during the past three years of any motoring offence?

Yes                                                    No          

Are you disqualified by an Court from holding or obtaining a driving licence?

Yes                                                   No          

If you have seven or more penalty points on your driving licence your application may be refused; it will depend upon the nature of the offences.

Have you ever held a Hackney Carriage or Private Hire Driver’s licence

Yes                                                   No          

If “yes” which Authority was it with?________________________________________________________

Badge number:______________

If “yes” indicate which of the following is applicable:

Current            Revoked          Suspended     Expired             Surrendered    

In any instance of a licence being held which type

Hackney Carriage          Private Hire                     Dual    

Name of company you will be driving for:

(if you will not be driving for a company please state ‘independent’)

 

 

PART 3

PREVIOUS CONVICTIONS ( If any)

State below details of your conviction/cautions (if any) for any offence (including pending Court appearances), whether driving or other offences.

If there are none state ‘NONE’. Please note that taxi drivers are not subject to the Rehabilitation of Offenders Act 1974 and you should give details of all convictions, including spent convictions and cautions as well as any pending matters.

If you would like to discuss what effect a conviction might have on your application you may telephone the Licensing Officer, in confidence, for advice on:

Maidstone – 01622 602255

Sevenoaks – 01732 227004

Tunbridge Wells – 01892 554034

 

Date of conviction/caution

Offence

Court

Sentence or Order

 

 

 

 

 

 

 

 

 

 

PART 4

GENERAL DECLARATION

 

IMPORTANT   I declare that all the answers given above are true. I understand that it is an offence under Section 57(3) of the Local Government (Miscellaneous Provisions) Act 1976 for any person to knowingly or recklessly make a false statement or omit any material particular in giving the required information.

 

Applicants signature:

 

 

Date:

 

 

Please enclose/produce the following documents with your application

OFFICE USE ONLY

 

UK Driving Licence (if you have a photo card licence you must produce both parts)

Disclosure and Barring Service (DBS) completed check form

Licence fee

Items/documents to be considered as part of the application

 

Medical Certificate

DVLA Mandate form

DBS Update service – Please provide your DBS Registration ID number

ID no:

*Driving Standards Agency test (DSA test) or *Transport Training test – new applicants only (please * delete as applicable)

Date passed:____________

Topography / Knowledge test – new applicants only

Date passed:____________

Routes score:______________

Streets score:______________

For Tunbridge Wells applicants – new applicants only

 

Seminar arranged on:___________________

Seminar attended yes no

 

Please telephone 01732 227004 for the up to date fee for the relevant Licensing Authority or go  to the website for the relevant  Licensing Authority.

 

Please return the completed form and fee at least ten working days before the renewal date, to:

 

The Licensing Partnership,

P.O. Box 182,

Sevenoaks, Kent,

TN13 1GP

(cheques must be made payable to ‘Sevenoaks District Council’)

 

You may have copies taken of your documentation at:

 

Maidstone Gateway between the hours of 10:00 – 13:00 hours Monday to Thursday.

Tunbridge Wells Gateway between the hours of 08:30 – 12:30 hours Monday to Friday.

Sevenoaks reception, Argyle Road between the hours of 08:45 – 17:00 hours Monday to Thursday     and 08:45 – 16:45 hours on Friday.

 

Note

New applicants: All new applicants will need to arrange an interview with the relevant Licensing Officer for the authority in which they wish to drive. Please see the telephone numbers above.

Renewals:    If, for whatever reason, there is a delay in submitting your application form in good time we may not be able to process your application in time for its renewal. We would recommend that you submit the application at the earliest opportunity

 

 

EQUAL OPPORTUNITIES MONITORING

 

We are asking you to complete this section as part of our equal opportunities monitoring. We wish to ensure we are treating all sections of the population equally, to which of these groups do you consider you belong to (PLEASE TICK ONE BOX)

 

                                WHITE

British                                                                    

Irish                                                        

Any other white background                    

(PLEASE WRITE IN) …………………………………………………………

                                BLACK OR BLACK BRITISH

Caribbean                                                               

African                                                                   

Any other black background                  

(PLEASE WRITE IN) ………………………………………………………

                                MIXED

White & Black Caribbean                                      

White & Black African                                           

White & Asian                                                                        

Any other mixed background

(PLEASE WRITE IN)……………………………………………………………..

                                ASIAN OR ASIAN BRITISH

Indian                                                                     

Pakistani                                                                

Bangladeshi                                                           

Any other Asian background                 

(PLEASE WRITE IN)…………………………………………………………….

Chinese

Other ethnic group                                 

(PLEASE WRITE IN)……………………………………………………………

Unwilling to respond                                              

GRANTED/REFUSED

Do you consider yourself disabled      YES     NO