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APPLICATION FOR TAXICAB OPERATOR LICENSE PAGE 1 OF 2 CITY OF MOSCOW TAXICAB OPERATOR LICENSE – NEW APPLICATION APPLICATION FEE: $62.00 Name: LAST FIRST MIDDLE (MAIDEN) Permanent Address: STREET CITY STATE ZIP Current Address: STREET CITY STATE ZIP Email Address: Home Phone: Cell Phone: Date of Birth: Social Security EMPLOYMENT INFORMATION Name of Taxicab Company: 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? THE CITY OF MOSCOW REQUIRES: 1. A processing fee of $62 with this Application which includes the background check and fingerprinting charges. Fee is nonrefundable. 2. A valid Driver’s License to be shown and copied. Fingerprints must be completed at the Moscow Police Department (155 Southview Ave). Call [PHONE REDACTED] for hours of fingerprinting. **Driver’s license number: State of Expiration Date: I authorize the City of Moscow to run my driver’s license number to check my driving history. Please initial (Continue to second page on the back of this sheet) ---PAGE BREAK--- APPLICATION FOR TAXICAB OPERATOR LICENSE PAGE 2 OF 2 Incomplete applications, false statements, failure to disclose criminal records, or applications without the necessary attachments will be returned and may result in denial or revocation of the taxicab operator license. READ CAREFULLY: I have read all of the above (including the entire Chapter 5 of Moscow City Code, Title 9 and in particular Section 9-5-13 and Section 9-5-14) 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. REQUIREMENT: SIGN IN FRONT OF A MOSCOW POLICE DEPARTMENT DEPUTY CLERK Applicant’s Signature Date ATTEST: Clerk/Deputy Signature Date License to be mailed ☐ or picked up ☐ Updated 11/7/2024