PRINCE GEORGE’S COUNTY
Department of Public Works & Transportation
TAXI
LICENSING SECTION
8401 D’Arcy Road, #100, Forestville, MD 20747
Phone: (301) 324-2719 Fax: (301) 333-5049
P.G. CHANGE OF VEHICLE APPLICATION
DATE: ______________
P.G. CERTIFICATE #: EXPIRES:
TAXICAB COMPANY: MEDALLION #:
NAME OF LICENSEE: PHONE #:
ADDRESS:
Street
City State Zip Code
DISCONTINUED VEHICLE:
Year: Make of Vehicle:
VIN #: Tag No:
Status of Vehicle: Scraped Sold Other:
REPLACEMENT VEHICLE:
Year: Make of Vehicle:
VIN #:
Tag No:""" "
The following information must be submitted with each change of vehicle:
• Copy of current motor vehicle registration Certificate of Registration PG
• State of Maryland Safety Inspection
Proof of Vehicle Liability Insurance
• Approved Prince George’s County Taxicab and Meter Inspection Report
•
Fee of $250.00 (Money Order or Cashier’s Check Only) Payable to Prince George’s County
•
Medallions or Affidavit for Lost/Damaged Medallions
I, hereby certify under the penalty of perjury that the facts set forth in this application are true to the best
of my information and belief.
Print Name of Transferee, Agent or Representative Signature of Transferee, Agent or Representative
(For Office Use Only)
Date: Received by: Entered in Database: Initials:
