Fee: $40.00
Late Penalty Fee: $5.00

APPLICATION FOR
CITY CHAUFFEUR'S LICENSE

In accordance with the terms and provisions of chapter 9, article 15, section 18-29, every individual desiring to drive a taxicab or limousine in the city of Plainfield, shall apply for an obtain a city of Plainfield chauffeur's license before driving or accepting employment to drive a taxicab.

A Chauffeur's License Is Non-Transferable.

APPLICANT DETAILS

Applicant Name: *
Applicant Email:
Phone Number:
Applicant Address: *
Age:*
D.O.B.*
Place Of Birth:
Citizenship: *
N.J. Driver's License No.*
Expiration Date:
Height:
Weight:
Hair Color:
Eye Color:

Distinctive Physical Characteristics:

Residences For Past Ten Years:
Previous Driving Experience:
Any previous criminal convictions?:

Any convictions of traffic violations during the last two years of date of application?

Has your driver's license or taxicab driver's license ever been suspended or revoked?:

Any known physical or mental handicaps that would prevent applicant from Operating a motor vehicle safely?:
Can applicant speak and understand the english language?:

List the name and addresses of three (3) references living in the city of plainfield:
Name(1):*
Address(1):
Name(2):*
Address(2):
Name(3):*
Address(3):
Give name of taxicab company for which you plan to work:
By signing below, the applicant certifies that he/she has read and understands that the provisions of chapter 9, article 15, section 18-29 of municipal code of the city of Plainfield, and that the foregoing statements made by him/her are true, and that no material information has been withheld on this application. I understand that if any of the above statements are willfully false, I may be subject to penalties as provided by law.
Please enter the verification
code in the box: *

I hereby declare that the information given in this application is true and correct to the best of my knowledge.
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