Received
Vehicle Inspection Report
Registration Book
Insurance
MOT Certificate
Receipt No
Licence No
First Issue/Renewal
Environmental Protection
& Licensing
Wiltshire Council
Bath Road
Devizes
Wilts
SN10 2AT
APPLICATION FOR A PRIVATE HIRE VEHICLE LICENCE
Notes to be read before completing this application form
1.
Please use block letters.
2.
A separate form must be completed for each vehicle to be licensed.
3.
A business, club or hotel address can be accepted provided the applicant lives there permanently.
4.
The vehicle must be considered by the Council to be suitable in type, size and design for use as a
hackney carriage vehicle and in a suitable mechanical condition.
5.
No vehicle over 4 years old will be granted an initial licence unless it is in exceptionally well-maintained
condition both with regard to the bodywork and mechanical condition.
6.
No vehicle over 7 years old will be re-licensed unless it is in exceptionally well maintained condition both
with regard to bodywork and mechanical condition.
7.
Authorised Officers maintain their discretion to grant licences for vehicles which fall outside the 4 and 7
year limits where they are satisfied that the vehicles are in exceptional condition and there is supportive
evidence by way of a AA/RAC or similar report.
8.
Details of ownership must state whether the owner is a company or partnership and, if so, either give
details of the company or each partner as applicable.
9.
The current insurance must be a policy issued in accordance with, and comply with, Part VI of the Road
Traffic Act 1972.
10. Registration document, insurance policy documents and MOT certificate must be inspected before a
hackney carriage vehicle licence is granted.
11. Cheques should be made payable to Wiltshire Council.
12. Licences will be valid for ONE year.
APPLICANT
1
Surname:
.............................................................................................................................
2
Forename(s):
.............................................................................................................................
3
Permanent address:
.............................................................................................................................
.............................................................................................................................
.............................................................................................................................
4
Telephone No.
(Home): ………………………………..(Work) …………………………………...
WILTSHIRE COUNCIL
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PHV application form
5
Is the operation of a private hire service your full-time business?
YES / NO
If NO, state your normal occupation ...............................................................................................................
6
Which Company will you be working for? ……………………………………………………………………….
VEHICLE
1
Make and model of vehicle
………………………………………………………………………………………..
2
Vehicle registration number ……………………………. 3. Engine capacity................................................
4
Colour ……………………………..
6
Hackney carriage plate number, (if previously issued) .................................................................................
7
Constructed to carry ………….
9
Number of doors
5. Date of first registration of vehicle .................................................
Persons (excluding driver)
8.
Wheelchair access: YES / NO
............ …….
10. Are you the sole owner of the vehicle? ……………………………….YES / NO
If NO, state name(s) and address(es) of every proprietor or part-proprietor concerned in the keeping,
employing or letting to hire of your vehicle (please continue on a separate sheet if necessary):
........................................................................................................................................................................
5
Have you, or a partnership of which you are, or were, or company of which you are, or were, a director
or secretary, ever been convicted of any criminal offences whatsoever? If so please list all offences
occurring within the last five years, giving the name of the Court, the conviction/penalty imposed and the
date of the hearing:
........................................................................................................................................................................
6
Name and address of the insurance company with whom you hold a full insurance for hire or reward:
........................................................................................................................................................................
7
Insurance policy number ………………………………….8. Date of expiry of insurance ...............................
OTHER FACTORS
Please state any factors which you wish to be taken in to account in considering your application (if
necessary, please continue on a separate sheet):
................................................................................................................................................................................
DECLARATION
NB: If any person knowingly or recklessly makes a false statement or omits any material particular in giving
the foregoing information (s)he shall, under section 57 of the Local Government (Miscellaneous Provisions) Act
1976 be guilty of an offence.
This authority 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 this purpose.
I declare that the information given by me in this application is correct in every respect and that I have read, and
understand, the conditions with which I would be required to comply if granted a licence.
Date: ............................................. Signed: ...........................................................................................................................
WILTSHIRE COUNCIL
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PHV application form
VEHICLE SPECIFICATION
With effect from 1st July 1989:
•
No vehicle over 4 years old will be granted an initial licence as a hackney carriage or private hire
vehicle unless it is in exceptionally well maintained condition both with regard to the bodywork and
mechanical condition.
•
No vehicle over 7 years old will be re-licensed as a hackney carriage or private hire vehicle unless
it is in exceptionally well-maintained condition both with regard to the bodywork and mechanical
condition.
(The age of the vehicle to be calculated from the date of first registration given in the registered
keeper’s document.)
Any vehicle submitted for licensing as a hackney carriage or private hire vehicle must be suitable for
such use, and without prejudice to that general requirement the vehicle must (unless it is a purpose-built
hackney carriage) comply with the following:
1
It must be of sufficient seating capacity to carry at least 4 and not more than 8 passengers in addition to
the driver. The seating capacity shall be determined in accordance with paragraphs (i)(a) and (I)(b) of
Regulation 42 of the Road Vehicles (Registration and Licensing) Regulations 1971 or any re-enactment
thereof:(a)
Rear seat (length): The length of the rear seat measured in a straight line lengthways on the front
of the seat must be such as will allow adequate seating accommodation to the
extent of at least 16 inches (400mm) per person.
(b)
Seats (width):
The width of the back seat from the squab to the front edge must be not less
than 18 inches (457mm).
(c)
Knee space:
The measurement between the rear of the front seats and the squab of the
back seat must not be less than 30 inches (762mm) with the front seat at its
centre point.
(d)
Height (inside):
From the top of the seat cushion at its junction with the rear squab vertically
must not be less than 32 inches (813mm).
Subject to the further consideration of vehicle wheelbase and engine size as follows:
Any vehicle with a wheelbase of 100 inches (2540mm) or more shall be licensed to carry 4 (or more to a
maximum of 8) passengers subject to engine size of 1550cc and above and seat measurement criteria
as at (a) (b) (c) and (d) above.
2
The vehicle must have a minimum of 4 road wheels and carry a spare wheel to the same specification
as the road wheels;
3
The vehicle must have at least 4 doors, excluding any tailgate. Sliding doors must be fitted with a
warning device to indicate when they are open;
4
If an estate-type vehicle, it must have sufficient luggage space for the number of passengers the vehicle
is licensed to carry without having to fold any seat and must be fitted with a guard between luggage and
passengers. Saloon-type vehicles must have a separate compartment for luggage;
5
The vehicle must be equipped and maintained with an efficient fire extinguisher of dry powder type
having a minimum capacity of 3lbs (1.36Kg), or two such extinguishers having in aggregate such
capacity, and complying with the specification of the British Standards Institution, such extinguisher or
extinguishers to be properly secured within the vehicle, and to which the driver shall have easy access,
and to be maintained in full and efficient working order at all times;
6
The vehicle must be equipped and maintained with a comprehensive first-aid kit containing such
dressings and appliances as may be required for use in an emergency, such first-aid kit to be located in
such a position as to be immediately available.
7
Meters are not required in private hire vehicles.
8
A certificate of roadworthiness is required in respect of all but brand new vehicles.
WILTSHIRE COUNCIL
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PHV application form
WILTSHIRE COUNCIL
HACKNEY CARRIAGE/PRIVATE HIRE VEHICLE
INSPECTION REPORT
This certificate is to be completed by a garage proprietor approved by the Department of Transport for the
compulsory testing of vehicles under the Road Traffic Act 1972 and submitted on application for grant or renewal of
a Hackney Carriage/Private Hire vehicle licence.
Note:- Any fee payable in respect of this inspection report must be paid by the vehicle owner.
1.
DETAILS OF VEHICLE
Make:
.............................................................................................................................
Registration Number:
.............................................................................................................................
Plate Number (if any):
.............................................................................................................................
Name of Applicant for Licence: .............................................................................................................................
Address of Applicant:
.............................................................................................................................
.............................................................................................................................
.............................................................................................................................
Telephone Number
2.
.............................................................................................................................
INSPECTION OF VEHICLE
Date: .................................................................................................
Time: .....................................................
Inspected by:
.......................................................................
Garage Stamp:
Signed:
.......................................................................
Name of Garage:
.......................................................................
Address:
.......................................................................
.......................................................................
Telephone Number
3.
.......................................................................
RE-INSPECTION AFTER ANY NECESSARY WORK COMPLETED
Date: .................................................................................................
Time: .....................................................
Inspected by:
.......................................................................
Garage Stamp:
Signed:
.......................................................................
Name of Garage:
.......................................................................
WILTSHIRE COUNCIL
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PHV application form
PTO
4.
VEHICLE SPECIFICATION - CERTIFICATION
Please read and check through the attached vehicle specification, taking the necessary measurements, and sign
either statement A or B below.
A: I have checked the vehicle identified overleaf and confirm that it does conform to the attached vehicle
specification.
Signed:
.................................................................................
Date: .....................................................
OR
B: I have checked the vehicle identified overleaf and found that it does not conform with the attached vehicle
specification for the following reasons:.........................................................................................................................................................................
.........................................................................................................................................................................
Signed:
.................................................................................
Date: .....................................................
Garage stamp:
5.
INSPECTION REPORT - CERTIFICATION
Please now check that the vehicle identified overleaf complies with the vehicle inspection report and complete
either statement A or B below:A: I have inspected the vehicle identified overleaf in accordance with the vehicle inspection report attached and
confirm that the vehicle is in a good roadworthy condition and that all items are serviceable.
Signed:
.................................................................................
Date: .....................................................
OR
B: I have inspected the vehicle identified overleaf in accordance with the inspection report attached. The vehicle
is not in a good roadworthy condition for the following reasons:
.........................................................................................................................................................................
.........................................................................................................................................................................
Signed:
.................................................................................
Date: .....................................................
Garage Stamp:
WILTSHIRE COUNCIL
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PHV application form
INSIDE
CHECK FOR
Windscreen Wipers,
Washers, Horns, Switches
OPERATION
Gauges, Warning Devices
OPERATION & LOCATION
Panel Lights
SECURITY / DAMAGE
Driving Seat
SECURITY / DAMAGE
Mirrors
SECURITY / DAMAGE
Air Vacuum
OPERATION / DAMAGE
Clutch & Throttle Controls
OPERATION / DAMAGE
Steering Wheels
PLAY / DAMAGE
Steering Column
SECURITY
Cab Floors & Steps
Seat Belts
UNSATISFACTORY
COMMENTS
BUILD UP / LEAKS
Brake Control
Upholstery
SATISFACTORY
VIEW / CONDITION
SECURITY/DAMAGE
SECURITY OF MOUNTINGS
CONDITION OF BELTS
OPERATION
GROUP LEVEL
Headlights
CHECK FOR
OPERATION / DAMAGE
Direction Indicators
OPERATION / DAMAGE
Cab Mounting
Doors, Locks
SECURITY/DAMAGE
Hubs & Wheels
Tyres
Tyre Condition
Body
Bumpers
Body Work
Towing Gear (If Fitted)
UNDER VEHICLE
SATISFACTORY
UNSATISFACTORY
COMMENTS
SECURITY
SECURITY/DAMAGE
Fuel Tank, Cap, Fuel Pipes
COMMENTS
EFFECTIVE REPAIR
Wings
Exhaust Smoke
UNSATISFACTORY
OPERATION / DIP
Side, Read, Stop Lamps
Accident Damage
SATISFACTORY
EXCESS
SECURITY / DAMAGE / LEAKS
CRACKS / NUTS /
RINGBUTTING
SIZE / COR. PAIRING
WEAR / DAMAGE / PRESSURE
SECURITY / DAMAGE /
CONDITION
SECURITY / DAMAGE
RUST
SECURITY
CHECK FOR
WILTSHIRE COUNCIL
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PHV application form
Chassis
CRACKS / LOOSE BOLTS OR
RIVETS
Spring Shackles, Brackets
SECURITY / DAMAGE
Suspension
SECURITY / FAILURE
Shock Absorbers
Engine Mountings
SECURITY / LEAKS
SECURITY / FAILURE
Pipes & Hoses
SECURITY / DAMAGE / LEAKS
/ CHAFING
Battery, Wiring
SECURITY / DAMAGE /
CHAFING
Exhaust System
SECURITY / BLOWING
Spare Wheel & Carrier
Oil Leaks
Steering Box & Linkage
Chassis, Integral
Construction Members
SECURITY / DAMAGE
EXCESS LEAKAGE
SECURITY / DAMAGE /
OPERATION
RUST
Transmission
SECURITY / DAMAGE / LOOSE
BOLTS
Brake Linings
WEAR / ADJUSTMENT
Brake Drums
SECURITY / CRACKS
Brake Linkage
Brake Wheel Units
Stub Axles, Wheel Bearings
Ancillary Equipment
ROAD TEST & SPEEDO
OPERATION
Transmission
Steering
Braking System
ADJUSTMENT / LOCKING
DEVICES
SECURITY / LEAKS
DAMAGE / SIGNS OF WEAR
SECURITY / DAMAGE
CHECK FOR
SATISFACTORY
UNSATISFACTORY
NOISE
ALIGNMENT
SERVICE BRAKE CONDITION
PARKING BRAKE CONDITION
SERVICE BRAKE EFFICIENCY
PARKING BRAKE EFFICIENCY
SERVICE BRAKE BALANCE
Engine
ACCELERATION
VALVES / TAPPETS
NOISE / VIBRATION
FUEL / CARB / IGNITION
MISCELLANEOUS ITEMS
WILTSHIRE COUNCIL
COMMENTS
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PHV application form
COMMENTS
Hackney Carriage Roof Sign
YES/NO
Plates: INTERIOR
YES/NO
EXTERIOR
YES/NO
Fire Extinguisher
YES/NO
First Aid Box
YES/NO
Seating Capacity
4 / 5 / 6 / 7
Recorded Mileage
Taximeter Fitted
YES/NO
Meter No.
Four Doors
YES/NO
Four Wheels
YES/NO
WILTSHIRE COUNCIL
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PHV application form