Approved by Chief of Police:
Date:
City of Plattsburgh, New York
Application for Taxicab Business License
To the City Clerk
Application is hereby made for a license permitting operation of taxicabs on the streets of the City of
Plattsburgh, NY.
Company Information:
Company Name (DBA):
Owner:
Address:
Business Telephone #:
Company Owner Information:
Have you ever been arrest? Yes No
If so; what for and were you convicted? _________________________________________________
Do you hold a valid NYS License as per section 501 of the Vehicle and Traffic Laws (Class E or C)?
Yes No
License #:
Class:
Expiration Date:
Length of Residence in NYS: ____________________
Has your license ever been suspended or revoked? Yes No
If so, please provide date, why, and where:
____________________________________________________________________________________
Car Information
This application is made for:
Make of Car:
Year:
VIN Number:
Seating Capacity:
NYS License Plate #:
Taxicab Owners Name:
Owners DOB:
Signature of Applicant:
Date:
**Office Use Only**
Date Received: _________________
Approved Disapproved
Taxi License #:
for the period
to
Issued this
day of
20
City Clerk
click to sign
signature
click to edit