Fillable GDPR Privacy notice Application for private hire vehicle (Elmbridge Borough Council)

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GDPR Privacy notice Application for private hire vehicle (Elmbridge Borough Council)

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Borough Council
... bridging the communities ...
Application for private hire vehicle executive status
GDPR Privacy notice
Who we are and what we do
Elmbridge Borough Council is the ‘Controller’ of any personal data that you provide
to us. We collect, process, and store your personal data in relation to your
application for a licence.
What we need to process your application
You must supply personal data including your name, address and contact details.
Why we need it
We use your personal and sensitive data to enable us to process your application. If
you do not provide this information we cannot process your application.
What we do with it
We will store your personal data in our licensing database and it will be accessed by
authorised Council employees. We will use your data to enable us to check
compliance with your licence, to carry out our enforcement duties and to contact you
about licensing matters. We may share your personal data with the other public
bodies and enforcement authorities for the purposes of investigation, to protect
public funds and prevent and detect fraud. We may also share your personal data
with insurance companies and the DVLA.
How long we keep it
If we do not grant your licence, we will keep your data for six years from the date of
the final decision on your application. If we grant your licence, we will keep your
data for the period of the licence and a further six years.
What are your rights?
Please refer to our corporate privacy policy at elmbridge.gov.uk/privacy-notices.
I
Application for private hire vehicle executive status
Application for private hire vehicle executive status
Local Government (Miscellaneous Provisions) Act 1976
You should use this form to apply for executive status for your private hire vehicle
licence or to renew your existing status.
Please read the guidance on our website elmbridge.gov.uk/licensing before you
complete this form. Please note, if you do not properly complete all our application
requirements, we will reject your application.
Section 1: Type of application
Private hire vehicle executive status
New
Renew
Section 2: Renewing your executive status
Only complete this section if you are renewing your current executive status
Existing private hire plate number
PHV
Expiry date
Section 3: About you (the applicant)
An individual
A partnership
A business or Ltd Company
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 2 of 11
Application for private hire vehicle executive status
Box A: Individual applicant
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Go to Section 4
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 3 of 11
Application for private hire vehicle executive status
Box B: Partnership first partner
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Box B: Partnership second partner
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 4 of 11
Application for private hire vehicle executive status
Post code
Date of birth
National insurance number
Go to Section 4
Box C: Business or Limited Company
Please complete all questions
Name of business or Ltd Company
Company number (if Ltd Company)
Preferred telephone number
Alternative telephone number
Email address
Company registered address
Post code
Go to Box D
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 5 of 11
Application for private hire vehicle executive status
Box D: Directors – first director
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Box D: Directors – second director
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 6 of 11
Application for private hire vehicle executive status
Post code
Date of birth
National insurance number
Box D: Directors – third director
Please complete all questions
Title
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Go to Box E
Box E: Company secretary
Please complete all questions
Title
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 7 of 11
Application for private hire vehicle executive status
First name and other forenames
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Section 4: The vehicle
Vehicle registration number
Date first registered
Make of vehicle
Model of vehicle
Colour of vehicle
Section 5: Your private hire operator
Name of your private hire operator
Your private hire operator’s licence number
Their operating address
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 8 of 11
I I I I
Application for private hire vehicle executive status
Section 6: Your driver
Name of the person who will be driving the vehicle
Driver’s badge number
HCD
PHV
Will anyone else be driving the vehicle
Yes
No
If you answered yes:
Name of the person who will be driving the vehicle
Driver’s badge number
HCD
PHV
Section 7: Details of the executive work
Will at least 90% of the work you intend to
carry out be executive hire work as defined in
our taxi and private hire licensing policy?
Yes
No
Will your customers normally be corporate or
business clients?
Yes
No
Briefly describe your client type
Describe the type of work you intend to carry out
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 9 of 11
Application for private hire vehicle executive status
Section 8: Relevant documents
I attach copies of the following documents (please tick)
Private hire operator records
Private hire operator’s statement
The correct fee
Section 10: Declarations
All persons listed in boxes A to E must sign this form
Under Section 57 Local Government (Miscellaneous Provisions) Act 1976 It
is a criminal offence to make a false statement or withhold information to
obtain a taxi or private hire vehicle licence. If convicted, you may be liable to
a fine up to level 3 on the standard scale.
I confirm that I have read the privacy notice on the first page of this
application form and I understand my rights in respect of that data
and consent to how the Council will process my personal data.
I confirm that I have read the Elmbridge Borough Council’s Taxi and
Private Hire Licensing Policy and that I am aware of the executive
conditions that will be applied to my licence if granted.
I understand I may have to produce the original documents referred
to above before the Council will my issue my taxi or private hire
vehicle licence.
I declare that the information contained in this form is correct
to the best of my knowledge and belief.
Please email your completed application form to licensing@elmbridge.gov.uk and
attach each of the documents listed in section 8 above. In the subject please write
“Application executive status:” followed by your name. We will only accept one file
for each document. Please do not send the documents as one large file, as
individual pages, or in separate emails.
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 10 of 11
Application for private hire vehicle executive status
Signature
Name
Date
Signature
Name
Date
Signature
Name
Date
Signature
Name
Date
VEHICLE_EXECUTIVE_EXEMPTION_V1.0 July 2020 11 of 11
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GDPR Privacy notice Application for private hire vehicle (Elmbridge Borough Council)

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Completed 21 January 2021

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