Application for a Private Hire / Hackney Carriage Vehicle Licence

This authority is under a duty to protect the public funds it administers, and to this end may use the information you provide on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes.
Application Type
What type of the vehicle licence you are applying for?*
- PRIVATE HIRE
- HACKNEY CARRIAGE
Application type*
- Grant
- Renewal
- Replacement
Licence Holders Details
I/We the undersigned being the proprietor(s) of a motor vehicle hereby request you to grant/renew/replace a licence for such vehicle to be used as a private hire / hackney carriage vehicle. I/we hereby state that the following particulars in respect of my/our application are to best of my/our application are to the best of my/our knowledge and belief correct.
Name*
First Last
Address*
Street Address Address Line 2 City Postcode
Telephone Number*
Email
Do you wish to add details of an additional licence holder?*
- Yes
- No

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Additional Licence holder's details
This authority is under a duty to protect the public funds it administers, and to this end may use the information you provide on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

To see more about how we record and store your information please go to:

https://www.hyndburnbc.gov.uk/privacy-notice/
Name*
First Last
Address*
Street Address Address Line 2 City Postcode
Telephone Number*
Email
Do you wish to add details of another additional licence holder?*
- Yes
- No
Another additional Licence holder's details
Name*
First Last
Address*
Street Address Address Line 2 City Postcode
Telephone Number*
Email

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This authority is under a duty to protect the public funds it administers, and to this end may use the information you provide on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes.

To see more about how we record and store your information please go to:

https://www.hyndburnbc.gov.uk/privacy-notice/
2. Please give the name and address of every person who is concerned either solely or in partnership with any other person in the keeping, employing or letting or hire of this vehicle.
Please click on (+) button to add more rows
Name Address Postcode
SCHEDULE OF PARTICULARS
Vehicle plate no:*
Date of first registration:*
DD slash MM slash YYYY
Registration number:*
Make & Type:*
Engine c.c.:*
Colour
Seating capacity (excluding driver)*
Please enter a number from 1 to 20.
Current licence No:
Insurance policy No:*
Insurance Company:*
Type of cover:*
Date of insurance:*
DD slash MM slash YYYY
Expiry date of insurance:*
DD slash MM slash YYYY

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PLEASE NOTE:–
- The vehicle cannot be licensed by another authority whilst licensed by Hyndburn Borough Council.
- The form must be accompanied by the following:-
(a) The vehicle registration certificate
(b) Certificate of insurance covering third party liability in respect of physical injury or death and in respect of damage to personal belongings. Contract/self-drive hire insurance in the case of a replacement vehicle supplied by a replacement vehicle company.
Operator Details
Name of operator:*
Address of operator:*
Street Address Address Line 2 City Post Code
Upload Documents
(a) The vehicle registration certificate
Accepted file types: jpg, gif, png, pdf, Max. file size: 32 MB.
(b) Certificate of insurance covering third party liability in respect of physical injury or death and in respect of damage to personal belongings. Contract/self-drive hire insurance in the case of a replacement vehicle supplied by a replacement vehicle company
Accepted file types: jpg, gif, png, pdf, Max. file size: 32 MB.

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Declaration
Hidden
Untitled*
I/we understand that the grant/renewal/replacement of a private hire / hackney carriage vehicle licence is subject to any statutory enactment or rule of law for the time being in force governing the same and to the terms and conditions of issue laid down by the Council (a copy of which has been previously given to me).

I/we understand that it is an offence, punishable on summary conviction by a fine not exceeding £1000, knowingly or recklessly to make a false statement or omit any material particular in the completion of this form. The making of such false statements or omissions may also result in the immediate suspension or revocation of the licence.

I/we confirm that the requested items have been uploaded in respect of this application :-
Signature*
Signature of additional license holder*
Signature of another additional license holder*

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Application Type

Name	Address	Postcode