Required fields are marked with asterisks (*)

Taxi Licence Application - Driver Form

This application is a:

New Application

Renewal

Name:

Civic address:

Mailing address (if different than civic address):

Primary Phone #:

Secondary Phone #:

E-mail address:

Drivers Licence #

Please attach a scan/picture of your drivers licence. (Otherwise you will be required to provide a copy at the Municipal Office). (2 MB limit)

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While working, will your insurance be covered by personal or a corporate insurance plan? (Select all that apply)

Personal

Corporate

MTO Drivers Abstract (Otherwise, you will be required to submit a copy to the Municipal Office): (2 MB limit)

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Police Criminal Record Check – Vulnerable Sector Preferable (Otherwise, you will be required to submit a copy to the Municipal Office): (2 MB limit)

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While working, will you be operating a vehicle personally owned or fleet owned? (Select all that apply):

Fleet

Personal

Notice of Collection: Personal information contained on this form is collected pursuant to the Municipal Act, and will be used for the purpose of issuing a Taxi Driver Licence. Enquiries regarding the collection of this information may be directed to the Office of the Clerk/Freedom of Information Coordinator, Municipality of Trent Hills, 66 Front Street South, Campbellford, ON K0L 1L0 705-653-1900

Land Acknowledgement

We recognize the traditional keepers of this land and, specifically our neighbours of the Alderville First Nation, with a formal territorial acknowledgement.

Welcome to the Gunshot Treaty Lands of 1788. It is on these lands and on the shores of the big lake, the Mississauga Anishinabeg met with the Crown to facilitate the opening of these lands for
settlement.

Let us be reminded of the responsibility we all have in making sure that we respect these lands and waters that give us life and sustain our livelihoods.