Full Text
Renewal Application for Taxicab Business Owner Licenses – Revised 12/17/24 Page 1 of 2 CITY OF MOSCOW TAXICAB BUSINESS OWNER LICENSE – RENEWAL APPLICATION THE CITY OF MOSCOW REQUIRES: 1. A processing fee of $15.50 per vehicle with this Application. Fee is 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: Date Original License was granted: Per Moscow City Code Section Title 9Chapter 5, every driver must obtain/renew a taxi operators license. DRIVER INFORMATION: – Please list all current drivers (already registered with the City): Name of Driver Phone # Name of Driver Phone # Name of Driver Phone # Name of Driver Phone # Name of Driver Phone # Name of Driver Phone # Name of Driver Phone # AUTOMOBILE INFORMATION: Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection ---PAGE BREAK--- Renewal Application for Taxicab Business Owner Licenses – Revised 12/17/24 Page 2 of 2 Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection Year, Make & Model: License Plate # Insurance Inspection 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. In the past 12 months, have you 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 In the past 12 months, has your driver’s license been suspended or revoked for any period of time? [ ] YES [ ] NO If yes, when, where, and for how long? READ CAREFULLY: I hereby certify under penalty of perjury pursuant to the law of the State of Idaho that the foregoing is true and correct and declare that since the previous application or report to the City of Moscow, there have been no changes in the business or my status as applicant, that I have not engaged in any activity that would result in my denial of a license or revocation of a license pursuant to Moscow City Code Title 9, Chapter 5 and that I am the qualified applicant for renewal of the license for which application is made under the laws of the City of Moscow and the State of Idaho. I understand that an investigation may be made on all information contained in this application and authorize the City to conduct such investigation. REQUIREMENT: SIGN IN FRONT OF A MOSCOW POLICE DEPARTMENT DEPUTY CLERK Applicant’s Signature Date ATTEST: Clerk/Deputy Signature Date