PART A: APPLICATION
Taxi Company Name: ______________________________________________________________________________
Business Address: _______________________________________Victoria, BC Postal Code:___________________
Phone: ___________________________ Fax: _________________________Cellular: ________________________
Owner (1) Name: __________________________________________________Date of Birth_______/_______/_______
Owner (1) Address: ________________________________________________ Postal Code:_____________________
Owner (2) Name: __________________________________________________Date of Birth: _______/_______/______
Owner (2) Address: ________________________________________________ Postal Code:_____________________
Limited / Incorporated Company Name: ________________________________________________________________
VEHICLE INFORMATION:
______________________________ ______________________________ ______________________________
Year Make Model Company Car Number
______________________________ ______________________________ ______________________________
V.I.N. Number PT Reference Number B.C. Licence Plate Number
APPLICATION FOR TRANSFER: (TO BE COMPLETED BY EXISTING LICENCE HOLDER)
I, _____________________________________________, hereby agree to transfer the licence described below, to
_______________________________________________ Decal #___________________ Licence #_______________
Signature of Licence Holder: ___________________________________________Dated: ________/_______/________
PART B: APPLICANT DECLARATION
During the past two (2) years has ANY person mentioned on this application been convicted of an offence, relating to the
conduct of a business or involving dishonesty, or is any prosecution for any offence of the same nature pending.
No
Yes, give full particulars: __________________________________________________________________________
The applicant declares that the above facts are correct, that an application for a business licence as set forth, is
hereby made, and that the applicant has complied with all applicable bylaws, regulations or statutes and will
comply with all future bylaws and amendments, relating to this application.
Applicant / Representative Name: ___________________________________________________________________
Applicant / Representative Signature: _________________________________ Date Signed: _______/_______/_____
PART C: POLICE APPROVAL PROCESS (FOR OFFICE USE ONLY)
APPROVAL for Chief Constable: ___________________________________________Badge Number: ______________
DATE APPROVED _______/ ______/ ______
OLD CITY DECAL OLD COM DECAL BL NO CITY DECAL COM DECAL
PROCESSED BY: _____________________________________ DATE PROCESSED________/_________/_________
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