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APPLICATION FOR TAXICAB BUSINESS OWNER LICENSE -REVISED 12/17/24 PAGE 1 OF 3 CITY OF MOSCOW TAXICAB BUSINESS OWNER LICENSE – NEW APPLICATION THE CITY OF MOSCOW REQUIRES: 1. A licensing fee of $15.50 per vehicle and a fingerprinting fee of $42.00, all of which are nonrefundable. 2. Proof of insurance for each vehicle (see Moscow City Code Title 9, Chapter 5, Section 5-7, for specific coverage requirements). 3. Certificate of Liability designating the City of Moscow as an insurance certificate holder (see Moscow City Code Title 9, Chapter 5, Section 5-7, for specific coverage requirements). 4. Completed Annual Taxi Inspection Form for each vehicle. 5. A valid Driver’s License or other DMV approved identification to be shown and copied. Today’s Date: Name of Business: Name of Owner: Address: Telephone: Home: Business: Fax: Email Address: Federal Tax Identification Number: Driver’s license number: State of Expiration Date: Per Moscow City Code Title 9, Chapter 5, Section 5-3, every owner and driver must supply a full set of fingerprints with every application and complete a full background check pursuant to MCC 9-5-13. Fingerprints must be completed at the Moscow Police Department (155 Southview Ave). Call [PHONE REDACTED] for hours of fingerprinting. Have you ever, anywhere or at any time, been found guilty of, plead guilty to, received a withheld judgment, or admitted to the elements of any offense listed in Moscow City Code Section 9-5-14? [ ] YES [ ] NO If any of the above events occurred, you must answer “YES” regardless of subsequent court action resulting in dismissal or expungement. Explain each event fully. Use supplemental paper if necessary. DATE OF EVENT PLACE OF EVENT OFFENSE RESULT Has your driver’s license ever been suspended or revoked for any period of time? [ ] YES [ ] NO If yes, when, where, and for how long? (Continue to second page on the back of this sheet) ---PAGE BREAK--- APPLICATION FOR TAXICAB BUSINESS OWNER LICENSE -REVISED 12/17/24 PAGE 2 OF 3 1st DRIVER INFORMATION Name of Driver (if different from above) Address Telephone: Driver’s License # 2nd DRIVER INFORMATION Name of Driver Address Telephone: Driver’s License # 3rd DRIVER INFORMATION Name of Driver Address Telephone: Driver’s License # 4th DRIVER INFORMATION Name of Driver Address Telephone: Driver’s License # Add additional drivers on second page or on a separate sheet of paper if necessary ---PAGE BREAK--- APPLICATION FOR TAXICAB BUSINESS OWNER LICENSE -REVISED 12/17/24 PAGE 3 OF 3 AUTO INFORMATION: Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Year, Make & Model: License Plate # State of Issue Proof of Insurance Attached Vehicle Inspection Form Attached Add additional vehicles below or on a separate sheet of paper if necessary IMPORTANT: Applications without the necessary attachments will be returned and may result in denial or revocation of the taxicab business owner license. For taxi regulations, please read Moscow City Code Title 9, Chapter 5. READ CAREFULLY: I have read all of the above including Moscow City Code Title 9, Chapter 5 and declare under penalty of perjury pursuant to the law of the State of Idaho that each and every statement made is true, correct, and complete. I understand that an investigation will be made on all information contained in this application and authorize the City to conduct such investigation. I understand that if any information contained in this application is incorrect it may result in a denial of a license being issued. REQUIREMENT: SIGN IN FRONT OF A MOSCOW POLICE DEPARTMENT DEPUTY CLERK Applicant’s Signature Date ATTEST: Clerk/Deputy Signature Date