Fillable GDPR Privacy notice Taxi or private hire vehicle (Elmbridge Borough Council)

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GDPR Privacy notice Taxi or private hire vehicle (Elmbridge Borough Council)

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Taxi or private hire vehicle 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
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
Taxi or private hire vehicle licence application form
Taxi or private hire vehicle licence
Local Government (Miscellaneous Provisions) Act 1976
You should use this form to apply for a new taxi or private hire vehicle licence or to
renew your existing vehicle 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.
If you wish to apply for executive status for your private hire vehicle, you must also
complete and submit the separate ‘executive status’ application form.
Section 1: Type of licence
Taxi
New
Renew
Private hire vehicle
New
Renew
Section 2: Renewing your licence
Only complete this section if you are renewing your current vehicle licence
Existing taxi plate number
HCV
Existing private hire plate number
PHV
Expiry date
Section 3: 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)
VEHICLE_V1.0 August 2020 2 of 13
Taxi or private hire vehicle licence application form
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
VEHICLE_V1.0 August 2020 3 of 13
Taxi or private hire vehicle 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
Home address
VEHICLE_V1.0 August 2020 4 of 13
Taxi or private hire vehicle licence application form
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
VEHICLE_V1.0 August 2020 5 of 13
Taxi or private hire vehicle 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
Home address
VEHICLE_V1.0 August 2020 6 of 13
Taxi or private hire vehicle licence application form
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
VEHICLE_V1.0 August 2020 7 of 13
Taxi or private hire vehicle 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 vehicle
Vehicle registration number
Date first registered
Make of vehicle
Model of vehicle
Colour of vehicle
Fuel type
Number of passenger seats (excluding the driver)
Does the vehicle have a sun roof
Yes
No
Does the vehicle have a dark tint applied to the
rear and/or rear side windows of the vehicle?
Yes
No
VEHICLE_V1.0 August 2020 8 of 13
Taxi or private hire vehicle licence application form
If you answered yes, What percentage of light is
transmitted through the windows?
Is the vehicle licensed as a taxi or private hire
vehicle with another authority?
Yes
No
If you answered yes
a) Which authority is the vehicle licensed with?
b) Licence plate number
c) Date licence expires:
Please give the full address where the vehicle will be kept when not in use as a
taxi or private hire vehicle
Is the vehicle wheelchair accessible?
Yes
No
If you answered yes
Is it a purpose-built wheelchair accessible vehicle?
Yes
No
Is it converted to be wheelchair accessible?
Yes
No
Section 6: Ownership of the vehicle
Are you the sole owner of the vehicle?
Yes
No
If you answered no, please give the name(s) of the
vehicle owner
Owner 1
Owner 2
Owner 3
VEHICLE_V1.0 August 2020 9 of 13
Taxi or private hire vehicle licence application form
Section 7: Other licence applications
Have any of the individuals listed in Boxes A to E
above, ever had any taxi or private hire licence
suspended, refused, or revoked?
Yes
No
If you answered yes, please give the:
(a) name of the Council that issued the licence
(b) reason for suspension, refusal, or revocation
Section 8: Convictions or cautions
Please read our Convictions Policy before you complete this section.
Has any individual 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:
Is any individual 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:
VEHICLE_V1.0 August 2020 10 of 13
Taxi or private hire vehicle licence application form
Section 9: 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(s)
Evidence of right to work in the UK
Certificate of motor insurance
Vehicle registration document
Letter of consent (if applicable)
MOT certificate
Individual Vehicle Approval (IVA) certificate (if applicable)
DVSA IVA Certificate M1 (if applicable)
The correct fee
VEHICLE_V1.0 August 2020 11 of 13
Taxi or private hire vehicle licence application form
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 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 taxi or private hire vehicle proprietor.
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
follow the guidance and attach each of the relevant documents listed in section 8
above. In the email subject please write “Vehicle application:” 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.
Signature
Name
Date
VEHICLE_V1.0 August 2020 12 of 13
Taxi or private hire vehicle licence application form
Signature
Name
Date
Signature
Name
Date
VEHICLE_V1.0 August 2020 13 of 13
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GDPR Privacy notice Taxi or private hire vehicle (Elmbridge Borough Council)

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Completed 21 January 2021

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