Municipal Building
135 Haddon Avenue
Haddon Township, NJ 08108		

Tele: (856) 854-1176
Fax: (856) 858-8335
Web: www.haddontwp.com	

APPLICATION FOR TAXI CAB OWNER’S LICENSE 
TO AVOID A DELAY IN THE ISSUANCE OF YOUR LICENSE, PLEASE COMPLETE APPLICATION IN ITS ENTIRETY. A TAXICAB OWNER’S LICENSE DOES NOT ENTITLE OWNER TO DRIVE TAXICAB WITHOUT ALSO OBTAINING A TAXICAB DRIVER’S LICENSE.
LICENSE EXPIRES ON DECEMBER 31, ANNUALLY
NAME OF APPLICANT:	
TRADE NAME OF BUSINESS:	
ADDRESS OF BUSINESS:	
MAILING ADDRESS:	
DAY TIME TELEPHONE #:____________________________________________________
EMAIL ADDRESS:__________________________________________________________________
Please Circle One:   INDIVIDUAL, PARTNERSHIP, CORP. or LLC 
IF INDIVIDUAL: Name, Home Address, Date of Birth, US Citizen
IF PARTNERSHIP: Name, Home Address, Date of Birth of each Partner, US Citizen IF CORPORATION: Name, Home Address, Date of Birth of each Officer, US Citizen IF LLC: Name, Home Address, Date of Birth of each member, US Citizen

NAME	HOME ADDRESS	DOB	POSITION HELD	US CITIZEN	

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________	 

VEHICLE: (see page 3 to register additional vehicles)
	PLATE NO.____________________________	
SERIAL NO.	
YEAR	
MAKE & MODEL	
COLOR	
LENGTH OF TIME CAB HAS BEEN IN USE: ___________________________________
PASSENGER CAPACITY (not including driver):	
LOCATION OF DEPOT:	
PRESENT MARKET VALUE OF VEHICLE:_____________________________________
PLACE WHERE VEHICLE CAN BE INSPECTED:_______________________________

DRIVERS INFORMATION:   
NAME	ADDRESS	DRIVERS LICENSE NO.

Has applicant or person(s) mentioned in this application ever been convicted of a crime? Yes or No
If yes, explain crime committed and date of violation: ________________________________________________________________________________________________________________________________________________________________________Number of weeks during which the vehicle to be licensed was used as a taxicab: ____________________________________________________________________________________
THE FOLLOWING MUST ACCOMPANY EACH APPLICATION:
1.	Application fee: single cab - $100.00, additional cabs - $20.00, 6 or more 	cabs (fleet) - $250.00. Transfer of license to a taxicab owned by same licensee - 	$5.00.
2.	Certificate of Liability Insurance (Section 214-5) listing Vehicle Identification 	Number(s)
3.	Power of Attorney (notarized)
4.	Schedule of Rates to be charged

The applicant hereby agrees to abide by each and every provision of state law and the ordinances of Haddon Township, including, but not limited to Chapter 214 or any taxicab license granted by the Board of Commissions of the Township of Haddon shall be subject to revocation.

______________________________________________________
Signature, Title and Date

FOR OFFICE USE ONLY: 

FEE PAID___________	CHECK NO.___________ CASH ___________ DATE __________

VEHICLE: 
PLATE NO. ____________________________	
SERIAL NO.	 ___________________________
YEAR __________________________________
MAKE & MODEL ______________________	
COLOR ______________________________	
LENGTH OF TIME CAB HAS BEEN IN USE _________________ 
PASSENGER CAPACITY (not including driver) ______________	
LOCATION OF DEPOT ____________________________________	
PRESENT MARKET VALUE OF VEHICLE __________________
PLACE WHERE VEHICLE CAN BE INSPECTED ____________
____________________________________________________________

VEHICLE: 
PLATE NO. ____________________________	
SERIAL NO.	 ___________________________
YEAR __________________________________
MAKE & MODEL ______________________	
COLOR ______________________________	
LENGTH OF TIME CAB HAS BEEN IN USE _________________ 
PASSENGER CAPACITY (not including driver) ______________	
LOCATION OF DEPOT ____________________________________	
PRESENT MARKET VALUE OF VEHICLE __________________
PLACE WHERE VEHICLE CAN BE INSPECTED ____________
____________________________________________________________

VEHICLE: 
PLATE NO. ____________________________	
SERIAL NO.	 ___________________________
YEAR __________________________________
MAKE & MODEL ______________________	
COLOR ______________________________	
LENGTH OF TIME CAB HAS BEEN IN USE _________________ 
PASSENGER CAPACITY (not including driver) ______________	
LOCATION OF DEPOT ____________________________________	
PRESENT MARKET VALUE OF VEHICLE __________________
PLACE WHERE VEHICLE CAN BE INSPECTED ____________
____________________________________________________________

VEHICLE: 
PLATE NO. ____________________________	
SERIAL NO.	 ___________________________
YEAR __________________________________
MAKE & MODEL ______________________	
COLOR ______________________________	
LENGTH OF TIME CAB HAS BEEN IN USE _________________ 
PASSENGER CAPACITY (not including driver) ______________	
LOCATION OF DEPOT ____________________________________	
PRESENT MARKET VALUE OF VEHICLE __________________
PLACE WHERE VEHICLE CAN BE INSPECTED ____________
____________________________________________________________

I APPOINT THE TREASURER OF THE TOWNSHIP OF HADDON MY TRUE AND LAWFUL ATTORNEY FOR THE ACCEPTANCE OF SERVICE OF PROCESS FOR:
(YEAR):_____________________________	(MAKE):
(VIN):
(YEAR): 	(MAKE):
(VIN):
(YEAR):_____________________________	(MAKE):
(VIN):
(YEAR):_____________________________	(MAKE):
(VIN):
(YEAR):_____________________________	(MAKE):
(VIN):
(YEAR):_____________________________	(MAKE):
(VIN):____________________________________________________________

______________________________OWNER’S SIGNATURE	
	__________________________________________PRINT NAME	

State of New Jersey 
                                                  
County of                                   

On this, the________day of __________, 20____, before me a notary public, the undersigned officer, personally appeared________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained.

In witness hereof, I hereunto set my hand and official seal.

                                                                      ___________________________                                                                       Notary Public