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!!!!!!!!TAXI LICENSING SECTION
8401 D’Arcy Road, #100, Forestville, MD 20747
Phone: (301) 324-2719 Fax: (301) 333-4059
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P.G. TRANSFER APPLICATION
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P.G. CERTIFICATE #: EXPIRES
CAB COMPANY T/A:
NAME OF CURRENT LICENSEE: _______________________________ PHONE #:
ADDRESS:
Street
City State Zip Code
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NAME OF TRANSFEREE: ______________________________________ PHONE #:
ADDRESS:
Street
City State Zip Code
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THE FOLLOWING MUST ACCOMPANY THIS FORM:
! An Application for Registration of Taxicab Certification along with a Money Order or Cashier’s Check payable to
Prince Georges County in the amount of $250.00.
! A Letter from the Certificate Owner Requesting Transfer of Certificate or a Recent Power of Attorney Showing you
have the Right to Request the Transfer in the Owner’s Behalf.
The Transfer Fee of $3,500 MUST be paid by Money Order or Cashier’s Check when You Are Notified of Approval of
Transfer, payable to Prince George’s County.
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
Date: Notary Public
My Commission Expires
_____________________________________________________________________________________________
(For Office Use Only)
Date: Approved by: Entered in Database: Initials:
