Fillable Private hire operators statement in respect of an (Elmbridge Borough Council)

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Private hire operators statement in respect of an (Elmbridge Borough Council)

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Private hire operator’s statement in
respect of an application for executive
vehicle 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/
Private hire operator’s statement in
respect of an application for
executive vehicle status
Local Government (Miscellaneous Provisions) Act 1976
You should use this form in support of an application by a private hire vehicle
proprietor to obtain executive status for a private hire vehicle.
Please read the guidance on our website elmbridge.gov.uk/licensing before you
complete this statement. Please note, if you do not properly complete this form, we
will reject the vehicle proprietor’s application.
Section 1: About you
Please complete all questions
Operator’s name
Licence number
PHO
Operating address
Post code
Preferred telephone number
Alternative telephone number
Email address
Section 2: About the private hire vehicle
Registration number
Private hire plate number
PHV
Licence expiry date
OPERATOR_STATEMENT_V1.0 July 2020 2 of 3
Private hire operator’s statement in respect of an application for executive vehicle status
Section 3: Details of the executive work
Describe the type of work you will use the vehicle shown in Section 2 for.
What percentage of the vehicle’s journeys will be executive private hire
work?
How many vehicles do you run?
How many of those vehicles currently hold executive status?
Will you have enough and ongoing
executive private hire work for this vehicle
Yes
No
for the next 12 months?
Section 14: Declarations
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 agree to produce my private hire operator records in support of the
application for private hire executive vehicles status for the vehicle
shown in section 2.
I confirm that I have read the Council’s taxi and private hire licensing
policy and that I am aware of the licence conditions for executive
status private hire vehicles if granted.
I declare that the information contained in this form is correct
to the best of my knowledge and belief.
Please send this form electronically to the vehicle proprietor.
Signature
Name
Date
OPERATOR_STATEMENT_V1.0 July 2020 3 of 3
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Private hire operators statement in respect of an (Elmbridge Borough Council)

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Completed 21 January 2021

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