Fillable Application for a residents parking permit (London Borough of Hammersmith & Fulham)

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Application for a residents parking permit (London Borough of Hammersmith & Fulham)

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The Application for a residents parking permit (London Borough of Hammersmith & Fulham) form is 4 pages long and contains:

  • 3 signatures
  • 29 check-boxes
  • 60 other fields

Country of origin: UK
File type: PDF

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OFFICE USE ONLY
7-day permit Customer number
Date Officer
Stationery number Permit number
Application for a residents parking permit
Address: H&F Direct, Pay and Park, PO Box 60820, London W6 9UZ
Phone: 020 8753 6681 Web: www.lbhf.gov.uk/parkingpermits Email: parkingpermits@lbhf.gov.uk
Please complete this form in full using BLOCK CAPITALS.
A. Are you applying for:
Residents’ Parking Permit (please note that this permit
type is not valid on housing estates and private roads)
Full permit - I have all the required documents
A 30-day temporary permit -
I do not have all the required documents
Residents’ Parking Permit for a housing estate
(off-street only)
Full permit - I have all the required documents
A 30-day temporary permit -
I do not have all the required documents
B. Green or fully electric vehicle discount
My vehicle produces 100g/km of CO
2
or less My ve
hicle is fully electric
(Details of CO
2
emissions and engine specifications can be found in your vehicle registration document).
SECTION 1: Your details
Surname: Title:
Forenames:
Date of birth:
D
D M M Y Y
Y Y
Address:
Postcode: Email:
Phone (Day): Mobile:
SECTION 2: Details of your vehicle
Vehicle registration number:
Is this a UK registration?
Yes No
Make, model and colour:
Is your vehicle greater than 2.28m in height?
Yes No
It is an offence to make a false declaration. Please measure your vehicle if you are unsure of its height.
SECTION 3: Duration of permit
First Permit Second Permit
I am applying for a 6 month permit
£71 £260
I am applying for a 12 month permit
£119 £497
I am applying for a 12 month permit
with the greener vehicle discount
£60
I am applying for a 12 month permit
with the fully electric vehicle discount
Free
I am applying for a 30 day temporary
residents parking permit
£119
I wish to pay by credit or
debit card. Please contact
me to obtain payment
I have enclosed a cheque
made payable to the
London Borough of
Hammersmith & Fulham
SECTION 4: Proof that you can drive
You must produce your driving licence as proof that you can drive. If you have a photo card driving
licence, we will only accept the photo card and not the paper counterpart.
Copy of current full driving licence enclosed
SECTION 5: Proof of vehicle ownership
You must produce photocopies of the following
documentation as proof that you are the main
user/keeper of the vehicle:
The vehicle registration document
(in your name and address as stated in section 1)
or
A hire or lease agreement from a hire/leasing
company for the vehicle
(in your name and address as stated in section 1)
If you use a company car you must provide the
following documentation:
A typed (not handwritten) letter on headed paper
from your company secretary or equivalent stating
that you are the sole/main user of the vehicle and
are a full time employee of the company.
NB the letter must be signed by the author.
and
The vehicle registration document, or hire or lease
agreement from a hire/leasing company for the vehicle
showing the name and address of the company.
SECTION 6: Proof of address
Please complete either (a), (b) or (c) within this
section:
(a) If you are registered with us for council tax please fill
in the details below and provide one further proof
of residency from the list in Section 7.
Council tax number (shown on your bill):
Please sign below to certify that you are the registered
council tax payer for the address shown in section 1
and to authorise us to check the information:
Signature:
Date:
D
D M M Y Y
Y Y
or
(b) If you are renting your property and are not registered
for council tax please provide a signed and witnessed
copy of your unexpired tenancy agreement. You will
also need to provide a copy of two further proofs
of residency from the list in Section 7.
or
(c) If you are not registered with us for council tax and
do not have a tenancy agreement please ask the
person registered to complete the following section.
You will also need to provide two further proofs of
residency from the list in Section 7.
Authorisation to access council tax (to be
completed by the registered council tax payer)
I hereby certify that I am the person registered for
council tax for the address detailed in Section 1.
I authorise (for the purpose of the Data Protection Act)
the Pay and Park office to access my council tax record
with respect to that address for the purpose of an
application for a residents parking permit.
If the council tax is in the name of a business/trust, we
need a letter from a manager/trustee on headed paper
authorising us to access the council tax record and
confirming by name that the applicant lives at that address.
Surname: Title:
Forenames in full:
Address (if different):
Council tax account number
Postcode:
I hereby confirm that (applicants name):
is a permanent resident at the address stated in Section 1
Signature:
Date:
D
D M M Y Y
Y Y
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SECTION 7: Independent proof of address
If you completed part (a) of Section 6 you will need to provide a photocopy of one document from the list below.
If you completed part (b) or (c) you will need to provide photocopies of two documents from the list below.
You can only provide one document from each group.
Please ensure the documents are in your name and address as stated in Section 1.
Current motor insurance certificate and schedule
Vehicle registration document
Current building or contents insurance policy
Latest gas, water, electricity, or telephone bill (landline
only) must be dated within the last 3 months
Latest payslip, pension slip or Inland Revenue notice of
coding bill, must be dated within the last 2 months
Latest credit card statement, latest bank statement,
building society book or store card statement must
show transactions within the last 2 months
If you are unable to supply the required proofs please contact us.
SECTION 8: Declaration
You must read each section below and sign to say that you have read and understood them fully.
(The person named in Section 1 must sign this declaration)
• I confirm that the address stated in Section 1 of this
form is my main home.
• I confirm that I am the main user and the keeper of
the vehicle specified in Section 2 of this form, and I
will not allow non-residents to use my permit to park
in the borough. If I stop living in the borough or stop
keeping and using the vehicle, I will return my permit
immediately. If not, I will be committing an offence
and may lose any refund that would be paid for a
returned permit.
• I confirm that the vehicle with the registration given
in Section 2 of this form is not designed for more
than 12 passengers (not including the driver) and is
less than 2.28 metres high.
• I understand that if my property has been designated
as ‘car permit free’ through either a Section 106
agreement or a planning condition then I will not be
able to obtain a residents parking permit, even if I
have been issued a parking permit in previous years.
• I confirm that if the permit is for use on a company
vehicle I will return the permit if I either stop living
in the borough or I am no longer employed by the
company. I understand that the permit remains the
property of the London Borough of Hammersmith
& Fulham.
• I confirm that I do not hold another valid resident
parking permit from any other local authority.
• I understand and accept that you may ask to visit
my home or carry out further investigations,
including contacting any relevant people, before or
after issuing a permit to make sure I have given the
correct address. If I refuse, I understand it is likely
that you will not give me a permit or will withdraw
my permit. In the circumstances, I also understand
that my vehicle may be removed if it is parked on
the public highway.
• I understand that all information provided by me and
held by H&F may be used or shared by H&F for the
following purposes:
Legal requirements
H&F will use all information held by us for the purposes
of law enforcement, regulation and licensing, criminal
prosecutions and court proceedings.
Prevention and detection of fraud
H&F may share and compare your information with
other council services and other organisations to make
sure the information is accurate, to protect public funds,
recover debt and/or prevent or detect fraud. These
other organisations include government departments,
other local authorities and private sector organisations
such as banks or organisations that lend money.
Staff and data processors
The information you give H&F will be used by our staff
and third parties who provide council services on our
behalf for the processing and issuing of parking permits
and for the administration of the parking permit service.
Developing and testing business applications
H&F may use the information you give us to maintain
and improve the services which we deliver, this
includes developing and upgrading the systems which
we use to process your information.
Corporate business intelligence
H&F may share the information you give us with other
council services for research and analysis purposes, to
help us design and improve the services we provide
and to identify and contact residents who may benefit
from them
Phone numbers and email addresses
When contacting us we will ask you for a contact
mobile phone number and email address. We may
use these details to contact you by text, email and
phone. We will only contact you about matters
relating to parking services.
Continued on next page
© Designed and published by Hammersmith & Fulham Council - August 2019 - 020 8753 1764
SECTION 8: Declaration (continued)
• I understand that all full permits (excluding temporary
permits which have not been upgraded - see next item)
will commence on the first day of the month in which
they are issued.
• I understand that temporary permits which have been
upgraded to a full permit will commence on the first day
of the month in which the temporary permit was issued.
• I understand that if I pay for a resident permit by cheque,
credit card or debit card and my bank refuses to make
that payment, the permit will be considered to be invalid
and I risk having my vehicle ticketed or removed.
• I understand that, in certain circumstances, the London
Borough of Hammersmith & Fulham may require me
to provide further evidence to support my application.
This may be in addition to any documentation
described within this application form.
• I understand that if I abuse the parking permit system
my permit will be withdrawn.
•
I have read and understood the instructions and notes
regarding this application form, as outlined in the
Guide to Parking Permits brochure. For further details
go to www.lbhf.gov.uk/parkingpermits
• I understand and accept that you may prosecute me if
I have given any information on this form which I know
is wrong or untrue.
• I understand that a 30 day temporary parking
permit cannot be exchanged or extended to 12
months (without further charge) until all the required
documents have been provided and accepted.
• I understand that a replacement permit will not
be issued unless the current permit is returned and safely
received by Pay and Park. (If we do not safely receive your
current permit you will not be entitled to a replacement
or a refund of any kind).
Signature:
Date:
SECTION 9: How to apply
• Apply by email: scan and email your completed
application form and supporting documents to
parkingpermits@lbhf.gov.uk.
• Apply by post: send your form, required proofs and
payment to H&F Direct, Pay and Park,
PO Box 60820, London W6 9UZ.
• Apply in person:
Please check our website www.lbhf.gov.uk/
parkingpermits or call 020 8753 6681 for further
information.
Green and Fully Electric Vehicle Discounts
A discount for green or fully electric vehicles can only
be applied on submission of evidence that the vehicle
complies with our requirements. Please ensure that you
are eligible for this type of parking permit before you
submit your application. Any applications received that
do not meet the criteria will be cancelled and you will
be asked to reapply.
Replacement permits
A replacement permit will not be issued unless the
current permit is returned and safely received by Pay
and Park. (Please remember to remove your permit
from the vehicle when selling or returning the vehicle.
If we do not safely receive your current permit you
will not be entitled to a replacement or a refund of
any kind).
D
D M M Y Y
Y Y
SECTION 10: Collection/Royal Mail
Pay and Reserve
(Please contact me when my permit
is ready for collection):
Phone:
Royal Mail (Please post my permit):
www.lbhf.gov.uk
Published by Hammersmith & Fulham Council
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Completed 6 September 2021

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