Oakland Taxi Details v1.0b

Company Name

Telephone #

Immediate Supervisor

Employment From:

Employement To:

PERMIT APPLICATION FOR A PERMANENT AND TEMPORARY DRIVER'S PERMIT
PENDING THE DETERMINATION OF A PERMANENT TAXICAB DRIVER'S PERMIT
APPLICATION (PURSUANT TITLE 5.64 OF THE OAKLAND MUNICPAL CODE)

Application For | |Applicant's Inforamtion| | Employment Experience | | Acknowledgement | | Permit Applying For |

Initial Permit Annual Renewal Duplicate Permit Additional Permit

If you have a unique id click here for Annual Renewal and other Permits

Permittee must , and by this application does hereby agree to , abide by all applicable provisions of the
California Vehical Code , Oakland Municpal Code Taxicab Standards Ordinance , and all other Rules and
Regulations of the Chief of Polce.Public Works Agency and City Admnistrator Office.

Applicant's Last Name: Applicant's First Name: Applicant's Mid Initials:
Residence Address: City: Zip:
Mailing Address: City: Zip:
Home Telephone #: Cell #: DOB:
Height: Weight:
Eye Color: Hair Color: Work Authorization
Are you a U.S. Citizen?

List other names (including nicknames) that you have used or been known by:

List other states where you have been licensed to operate a motor vehicle , the names under which license was granted , and the license number :

Company Name Telephone #
Address City: Zip:
Immediate Supervisor Employment From: Employement To:

I, (print name), hereby acknowledge and agree that this is a temporary taxi driver permit, issued at my request pending determination of whether my application for a regular taxi driver permit shall issue , and as such it is revocable at any time in the sole discretion of the City Administrator right of appeal therefrom.
I am aware of the requirments of the Oakland Municiple Code, Taxicab Standard Ordinance and i understand that any omissions or untrue statements are cause for denial of this application.
Date :    Signature :



Company Name Address
Telephone Number City
Zip Code Applied On

Applicant's Last Name:	Applicant's First Name:	Applicant's Mid Initials:
Residence Address:	City:	Zip:
Mailing Address:	City:	Zip:
Home Telephone #:	Cell #:	DOB:
Height:	Weight:
Eye Color:	Hair Color:	Work Authorization
Are you a U.S. Citizen?