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Application for Licence to Drive a Private Hire Vehicle
Page 1 of 13
Your Details
All sections must be completed or may be rejected
Title
Mr
Mrs
Miss
Dr.
Prof.
Maj.
Sir
Surname
mandatory field
Forenames
mandatory field
Home Address
mandatory field
Post Code
mandatory field
Telephone Number
mandatory field
Mobile Number
Date of Birth
mandatory field
Date of Birth Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Date of Birth Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date of Birth
Year
NI Number
mandatory field
eMail Address
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