Fillable GDPR Privacy notice Private hire operators licence application (Elmbridge Borough Council)

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GDPR Privacy notice Private hire operators licence application (Elmbridge Borough Council)

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Private hire operator’s licence application form
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
We require you to provide 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 poli y at elmbridge.gov.uk/privacy-noticesc
Private hire operator’s licence application form
Private hire operator’s licence
Local Government (Miscellaneous Provisions) Act 1976
You should use this form to apply for a new private hire operator’s licence or to
renew your existing operator’s licence.
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 licence
Private hire operator
New
Renew
Section 2: Renewing your licence
Only complete this section if you are renewing your operator's licence
Existing private hire operator number
Expiry date
Section 3: Period of your licence
We will normally grant a private hire operator’s licence for three years unless
there is an appropriate reason to grant for a lesser period. If you would like
us to consider granting your licence for a period less than three years,
please explain why:
OPERATOR_V1.0 June 2020 Page 2 of 15
Section 4: About you (the applicant)
An individual
(Go to Box A)
A partnership
(Go to Box B)
A business or Ltd Company
(Go to Box C)
What is your trading name?
How many vehicles do you intend to operate?
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 5
OPERATOR_V1.0
June 2020 Page 3 of 15
Private hire operator’s licence application form
Private hire operator’s licence application form
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
OPERATOR_V1.0 June 2020 Page 4 of 15
Private hire operator’s licence application form
Home address
Post code
Date of birth
National insurance number
Go to Section 5
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
OPERATOR_V1.0 June 2020 Page 5 of 15
Private hire operator’s licence application form
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
OPERATOR_V1.0 June 2020 Page 6 of 15
Private hire operator’s licence application form
Home address
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
OPERATOR_V1.0 June 2020 Page 7 of 15
Private hire operator’s licence application form
Box E: Company secretary
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
Section 5: The premises
Please give the address at which you
intend to carry on business as a private
hire operator
Post code
Telephone number at address
Alternative telephone number
Business email address
OPERATOR_V1.0 June 2020 Page 8 of 15
Private hire operator’s licence application form
Do you intend to have a public waiting
room at the premises?
Yes No
If yes, how many people will you allow
to wait at any one time?
Section 6: Controllers
Please give details of all persons that will be taking bookings on behalf of
the private hire operator other than the people listed in boxes A to D above
Controller 1
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
Controller 2
Title
First name and other forenames
OPERATOR_V1.0 June 2020 Page 9 of 15
Private hire operator’s licence application form
Last name
Preferred telephone number
Alternative telephone number
Email address
Home address
Post code
Date of birth
National insurance number
Controller 3
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
OPERATOR_V1.0 June 2020 Page 10 of 15
Private hire operator’s licence application form
Controller 4
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
Section 7: Convictions or cautions
Please read our Convictions Policy before you complete this section.
Have any of the individuals listed in Boxes A to E above,
ever been convicted of or received a caution for any
offence (including motoring offences)?
Yes
No
If yes, please give details:
Are any of the individuals listed in Boxes A to E above
currently the subject of any investigation by the police or
any other authority (including motoring offences)?
Yes
No
If yes, please give details:
OPERATOR_V1.0 June 2020 Page 11 of 15
Private hire operator’s licence application form
Section 8: Applicant status (current)
Only complete this section if you are renewing your operator’s licence
Is any individual listed in Boxes A to E above, currently a
company director or company secretary of a limited
company?
Yes
No
If yes, please give details:
Name of individual
Company name and number
Please give details of any convictions
against the company
Section 9: Applicant status (historical)
Only complete this section if you are renewing your operator’s licence
Is any individual listed in Boxes A to E above, currently a
company director or company secretary of a limited
company?
Yes
No
If yes, please give details:
Name of individual
Company name and number
Please give details of any convictions
against the company
OPERATOR_V1.0 June 2020 Page 12 of 15
Private hire operator’s licence application form
OPERATOR_V1.0 June 2020 Page 13 of 15
Section 10: Other licence applications
Do any of the individuals listed in boxes A to E above, hold
or have they ever held a private hire operator’s licence
issued by Elmbridge Borough Council, any other Council,
or the Public Carriage Office/Transport for London?
Yes No
If yes, please give the name(s) of the council or authority:
Have any of the individuals listed in Boxes A to E above,
ever had any private hire operator’s licence suspended,
refused, or revoked?
Yes No
If yes, please give the:
(a) Name of the Council who issued
the licence:
(b) Reason for suspension, refusal, or
revocation:
Section 11: Relevant documents
I attach copies of the following documents in respect of all individuals listed
in Boxes A to E above
Data Barring Service (DBS) Basic Certificate
Evidence of my registration with the DBS Update Service
Overseas criminal record disclosure (if applicable)
Photograph
Evidence of right to work in the UK
Child sexual exploitation training pass certificate
Planning permission or evidence that permission is not required
The correct fee
Private hire operator’s licence application form
Section 9: 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 private hire operator’s 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 its Convictions Policy.
I confirm that I have a right to work in the UK. I understand that the
Council will check my immigration status and will refuse my
application if I am not legally present in the UK or if I am not allowed
to work in the UK as a private hire operator.
I understand I may have to produce the original documents referred
to above before the Council will my issue my private hire operator’s
licence.
I declare that the information contained in this form is correct
to the best of my knowledge and belief.
Signature
Name
Date
Signature
Name
Date
OPERATOR_V1.0 June 2020 Page 14 of 15
Private hire operator’s licence application form
Signature
Name
Date
Signature
Name
Date
Signature
Name
Date
OPERATOR_V1.0 June 2020 Page 15 of 15
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GDPR Privacy notice Private hire operators licence application (Elmbridge Borough Council)

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Completed 21 January 2021

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