Application to Renew a Private Hire or Hackney Carriage Driver Licence

Application to renew a Private Hire & Hackney Carriage Driver Licence
Self-Certification Statement Form for Private Hire or Hackney Carriage Drivers' who are applying to renew their existing licence during the COVID-19 pandemic.
Before you start...
If you require a new DBS then please submit your application online at https://www.personnelchecks.co.uk/taxis/taxiprivate-hire-driver-dbs-checks/ make a note of your payment receipt number, starting with WEB-PChecks-, so that you can enter it on this application form. This form asks you to upload your right to work documents, please have them to hand. It also asks for the DVLA check code. When uploading documentation such as your Medical Certificate, please place your document on a flat surface and take a photograph from above so that the content can be easily read by the Licensing Officer. You are required to upload a copy of your DVLA Photocard Licence and a Passport Style photo - this can be a self taken photograph with a plain background.
1. Application Online Payment Reference

Please make payment using the online Licensing Fund for your 3 year licence fee, please select as appropriate - New Private Hire Driver Licence or New Hackney Carriage Driver Licence.
2. Online Payment Reference Number for an additional Private Hire or Hackney Carriage Badge (if required):

If you are applying for a Private Hire Driver licence and require a Hackney Carriage Driver licence, please make a separate payment of £23.60 to also be issued with this licence.

Contact Details
Your personal details, please insert the following information as it appears on the licence that you wish to extend.
1. Name

First name

Last name
2. Address

Address Line 1

Address Line 2

City

County

Postcode

Country
3. Email
4. Phone
5. National Insurance Number:
6. Upload: Passport Style Photograph

This can be a self taken photograph aslong as it is taken with a plain background and clearly shows your profile - head and shoulders. Please do not wear sunglasses or hat which may obscure your face.

Licence Details
1. Badge Number:
2. Licence Expiry Date:
3. Name of Private Hire Operator (if applicable):

DBS Information
If you are due to submit a DBS, please provide your reference number. Your reference number from Personnel Checks should begin with WEB-PChecks- You can sumit an online application for a DBS Certificate at https://www.personnelchecks.co.uk/taxis/taxiprivate-hire-driver-dbs-checks/
1. Online DBS Reference Number:
Statement of Licensing Policy on the Handling of Disclosure Information
• Trafford will ensure that Disclosure information is not passed to persons not authorised to receive it under section 124 of the Police Act 1997; • Trafford will ensure that Disclosures and the information they contain are available only to those who need to have access in the course of their duties; • Trafford will securely store Disclosures and the information they contain; • Trafford will neither retain Disclosures nor a record of Disclosure information contained within them for longer than is required for the particular purpose. In general, this will be no later than six months after the date on which the relevant decision has been taken, or after the date on which any dispute about the accuracy of the Disclosure information has been resolved. This period will be exceeded only in very exceptional circumstances which justify retention for a longer period. This statement is made in accordance with the ‘Code of Practice and Explanatory Guide for Registered Persons and other recipients of Disclosure Information’ published by the Criminal Records Bureau. A copy of the Code of Practice is available on request from Trafford Council’s Licensing Office. For further information on Trafford’s Policy regarding the use of Criminal Records to determine new applications for Hackney Carriage or Private Hire driver licences please refer to Trafford’s website www.trafford.gov.uk (Licensing/A to Z of licences/Taxi driver’s licence/Related forms section)
2. I have read the Enhanced Check Privacy Policy for applicants http://www.gov.uk/government/publications/dbs-privacy-policies and I understand how DBS will process my personal data and the options available to me for submitting an application.
Yes, I I confirm I have read the Enhanced Check Privacy Policy

DVLA Information
1. DVLA Check Code:

DVLA ‘check code’ number: This number is available from the DVLA ‘View or Share Your Driving Licence Information’ and can be obtained from www.gov.uk/view-driving-licence You will need your DVLA driver licence number, national insurance number and your postcode to access your record and obtain the DVLA ‘Check Code’ number. This code number must be copied onto this form in the exact same format as displayed on the DVLA website, including capital letters and lowercase letters.
2. Upload: Photo Card Driving Licence

Right to Work
If you do not hold a UK or EU passport/national identity card, or a UK birth certificate, you must have a current valid passport from your country of origin and your biometric residency permit and/or proof that you have the right to work and remain in the UK. Visas in expired passports cannot be accepted. It is for you to prove you have the right to work and remain in the UK. Please note additional information may be requested by the licensing team in relation to this matter.
1. Do you have the right to live and work in the UK?
YesNo

For non-UK applicants, you must produce your passport, resident permit and/or visa.
1. Upload: UK or EU passport/national identity card or a UK birth certificate:
2. If you do not have the above documents, please provide full details of what documentation you have as proof that you have the right to work and remain in the UK:
3. Upload: Alternative Documentation

Declaration of Justice
Declaration of arrests/convictions/cautions/restorative justice/other disposals/etc. - please tick √ the appropriate box. Please note additional information may be requested by the licensing team in relation to this matter.
1. Have you been arrested, convicted or cautioned in relation to any offence(s), been subject to restorative justice or any other disposal, etc. since your last licence was issued?
YesNo

For further information regarding offences please see the Council’s Convictions Policy, which is available to view on the Council Website
If your answer to this question is yes, please provide full details below including the date, the name and location of the convicting court, details of the offence(s), sentence or other disposal, imposed, etc. and any other details you think relevant:

If you disclose something in this form which questions your suitability under the ‘fit and proper’ test, contained in the Local Government (Miscellaneous Provisions) Act 1976 and in the Council’s Convictions Policy, then you may be referred to the Public Protection Sub-Committee. If the matter impacts on public safety, then an emergency decision may be required. In these circumstances a referral is to the Director in conjunction with the Chair of the Committee and/or Executive Member. The Sub-Committee or Director will determine whether or not you will be permitted to continue to hold the licence. You are entitled to continue to drive a licensed private hire vehicle pending this decision, unless otherwise advised by the Council. A licence is issued without prejudice to any decision that the Sub-Committee or Director may make, and this may include the suspension or revocation of your licence.

Declaration of Motoring Offences
Please tick √ the appropriate box. Please note additional information may be requested by the licensing team in relation to this matter:
1. Have you been subject to any motoring offences including fixed penalty notices, convictions, fines, etc. since your last licence was issued?
YesNo
If you answer yes to this question, please provide full details below including the date, the name and location of the convicting court, details of the offence(s), sentence, fine or other disposal imposed and any other details you think relevant:

Declaration of Medical Fitness
Please tick √ the appropriate box. Please note additional information may be requested by the licensing team in relation to this matter:
1. Has anything changed since your last medical declaration which your GP signed when you last submitted a Medical Report?
YesNo
If your answer to this question is yes, please provide full details below including the condition, treatment, medication and any other details you think relevant:
2. Are you receiving treatment for any medical issues which you have not already made us aware of and is not covered under a statement of medical fitness, medical report or certificate of medical fitness last provided to the Licensing Authority?
YesNo
If you answer yes to this question, please provide full details below including the condition, treatment, medication and any other details you think relevant:
Medical Certificate
If you are due to update your Medical Certificate, please use the upload options below.
Upload: Medical Certificate (Page 1)
Upload: Medical Certificate (Page 2)
Upload: Medical Certificate (Page 3)

Fit and Proper Declaration
Fit and Proper Declaration for any other reason - Please tick √ the appropriate box. Please note additional information may be requested by the licensing team in relation to this matter:
WARNING! You are warned that should you fail to declare any convictions, cautions, arrests, restorative justice or any other disposals, fixed penalty or non-conviction this includes motoring offences, when completing this form, you may be prosecuted by the Council. Trafford Council can refuse, suspend or revoke a licence based on incorrect or incomplete information provided in your application. Do not be tempted to omit any information because you are not sure if it must be declared or not, the Council will make this assessment and disregard anything deemed irrelevant. A non-conviction is defined as: any breaches of licensing condition, any complaint, any allegation, any intelligence made available to the Council by the Police, private hire operator or any other partner agency or service, anything considered by a Court that has not resulted in a conviction e.g. acquittal or failure to reach a verdict, any other matter which questions the person’s ability to meet the ‘fit and proper’ test. You must also include details of any pending prosecutions for motoring or criminal offenses.
1. Do you currently hold a Private Hire or Hackney Carriage Driver Licence with another Licensing Authority?
YesNo
If yes to the above question, which other Licensing Authority?
2. Have you previously held a Private Hire or Hackney Carriage Licence with another Licensing Authority?
YesNo
If yes to the above question, which other Licensing Authority?
3. Have you ever been refused a Private Hire or Hackney Carriage Driver Licence by any Licensing Authority?
YesNo
If yes to the above question, which other Licensing Authority?
4. Have you ever had a Private Hire or Hackney Carriage Driver Licence suspended or revoked by any Licensing Authority?
YesNo
If yes to the above question, please provide details:
5. Have you ever surrendered a Private Hire or Hackney Carriage Driver Licence?
YesNo
If yes to the above question, please provide details:
6. Including motoring and criminal convictions, do you have any impending prosecutions?
YesNo
If yes to the above question, please provide details:
7. Is there anything else you need to declare which may affect your fitness to drive a private hire or hackney carriage vehicle?
YesNo
If you answer yes to this question, please provide full details below including details of any non-convictions:

Statement of Declaration for a Private Hire and Hackney Carriage Driver's Licence
Applicants are advised that to make knowingly or recklessly a false statement or omit any material information from this application is a criminal offence.
1. I declare that to the best of my knowledge and belief the answers given in this form are true. I understand that if I knowingly or recklessly make a false statement or omit any material particular from any part of the form, which includes a medical declaration and conviction declaration, or any other document I’m requested to submitted in support of this application, I shall be guilty of an offence which is punishable by a fine of up to £1000.00.
Yes, I agree
2. I declare that the information given in this application is true. If a Licence is granted, I undertake to comply with all the conditions attached to the said Licence. I understand that if I neglect to comply with any of the conditions, Acts or Bye-laws subject to which the Licence is held, the Licence shall be liable to be revoked or not renewed by Trafford Council Licensing Authority.
Yes, I agree.
3. I understand it is illegal for me, my family or customers to smoke in a Private Hire or Hackney vehicle at any time.
Yes, I understand.
Trafford Council is under a duty to protect the public funds it administers, and to this end may use the information you have provided 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. For further information, see http://www.trafford.gov.uk/about-your-council/data-protection/privacy-notices/level-2-fair-processing-notice.aspx or contact Trafford Council's Audit & Assurance Section on (0161) 912 1275.

Ethnic Monitoring Form
Trafford Council is committed to eliminating unlawful racial discrimination and promoting equality of opportunity and good relations between individuals and communities. To enable the Licensing Section to monitor its current practices to ensure that they comply with the Council's general commitment to the Race Relations (Amendment) Act 2000, would you please complete this monitoring form.
Please select from the drop down menu which option you believe best describes your ethnic origin. Your ethnic origin is not related to your nationality, place of birth, or citizenship. It describes your colour and broad ethnic group. UK citizens can belong to any of the groups indicated below.