Application for authority to assign a taxi-cab licence - Victorian Taxi ...

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Victorian Taxi Directorate Application for Authority to Assign a Taxi-cab Licence Under section 150 of the Transport (Compliance and Miscellaneous) Act 1983 (Vic) (the Act), the holder of a taxi-cab licence may apply for authority to assign the right to operate a vehicle under the licence. A separate application is required in respect of each assignment. The application pages headed “Application for Authority to Assign a Taxi-cab Licence – Assignor” and “Application for Authority to Assign a Taxi-cab Licence – Assignee” must be completed and provided to the Victorian Taxi Directorate (VTD) with all documents specified below in order for the application for authority to assign to be granted. All applications for authority to assign a taxi-cab licence must be submitted to the VTD. You may wish to use a designated taxi-cab licence trader to facilitate the assignment of a taxi-cab licence. A list of designated taxi-cab licence traders can be obtained by visiting the VTD website at www.taxi.vic.gov.au. Application requirements The following is required: 1. Completed application form. 2. Non-refundable application fee. For the current fee amount, please refer to the VTD website. 3. Accreditation certificate. A copy of the “Certificate of Accreditation as a Taxi-cab Operator” of the proposed assignee. 4. Letter of acceptance from the Network Service Provider with which the taxi-cab is to be affiliated. 5. Copy of executed Agreement to Assign a Taxi-cab Licence. An assignment agreement must be provided (copy is sufficient). The agreement must: a) state the licence number, period of assignment, the price and (if a vehicle is to be purchased) separately state the vehicle purchase price; b) be signed by the parties; c) show that the name(s) of the assignor is/are identical to the name(s) on the licence; and d) show the date of the agreement. Note: A VTD endorsed assignment agreement is available from the VTD website. 6. Authority to Act. If a designated taxi-cab licence trader is involved with the assignment of the licence, a copy of the ‘Authority to Act’ must be submitted. 7. Certified copies of Proof of Identity (POI) must be submitted for the responsible person of the assignor if the assignment of the licence does not involve a designated taxi-cab licence trader. DOT6105_F176_10/12 2 Who should sign this form? The signatory or signatories to this form for each of the assignor and assignee must be: For an individual – the individual. State “assignor”/“assignee” as “Role of signatory”. For a partnership – (1) a partner or partners authorised by a written partnership agreement (if any) to sign (attach the relevant extract from the partnership agreement giving this authorisation); or (2) if there is no written partnership agreement, all partners. State “partner” as “Role of signatory”. For a company (with more than one director) – two directors of the company, or a director and a secretary of the company. State “director” or “secretary” (as appropriate) as “Role of signatory”. For a proprietary company that has a sole director – that sole director of the company. State “director” as “Role of signatory”. For a co-operative – two directors of the co-operative, or one director and one officer of the co-operative. State “director” or “officer” (as appropriate) as “Role of signatory”. For an incorporated association – two members of the committee of management, or a person or persons otherwise authorised by the rules of association to sign (if the latter, attach the relevant extract from the rules giving this authorisation). State “member of committee of management” or “person authorised to sign by rules of association” (as appropriate) as “Role of signatory”. For a body corporate (other than a company, co-operative or incorporated association) – appropriate signatories will depend on the nature of the body corporate. Consult a VTD Officer to determine who should sign and in what role(s). Note: • Where a taxi-cab licence is subject to a “non-assignment” condition under section 143D(1)(b) of the Act, the VTD will not authorise the assignment. • The application must be refused if the assignee is not accredited as a Taxi-cab Operator under Division 4 of Part VI of the Act. • The vehicle that is to be operated on the licence must be registered in the name of the approved assignee. • An incomplete application will be returned to the transferor or the designated taxi-cab licence trader. Department of Transport Victorian Taxi Directorate, Level 23, 80 Collins Street, Melbourne VIC 3000 GPO Box 2797, Melbourne VIC 3001 Phone: 1800 638 802 (toll-free) www.taxi.vic.gov.au Authorised by the Victorian Government, 80 Collins Street Melbourne 3000. October 2012
Victorian Taxi Directorate Application for Authority to Assign a Taxi-cab Licence – Assignor To be completed by Assignor: Taxi-cab Licence No. Assignor Designated Taxi-Cab Licence Trader ID No. (if applicable) Licence Holder Accreditation No. DOT6105_F176_10/12 LHA– DETAILS OF APPLICANT (Assignor) Individual applicants: Surname/Family name First name/Given name Non-individual applicants: Name of Company, Partnership or Other Entity Responsible Person Address Postal address (if different from above) Telephone No. Home/Business Mobile Fax Email Postcode Postcode What is the name of the Network Service Provider with which the taxi-cab is currently affiliated? (if applicable) If a designated taxi-cab licence trader is involved with the assignment of the licence, please tick the following box to check that you have provided the following document: Authority to Act 3 DECLARATION I/We, the undersigned, being the assignor, declare that all answers to the questions in this form are, to the best of my/our knowledge, true and correct. I/We have read and understood the Privacy Statement set out on the back page and I/we hereby consent to the Secretary to the Department of Transport (SDT) and the Department of Transport (DOT) collecting, storing and retaining all information (including personal and sensitive information) obtained from me/ the assignor, any relevant persons in relation to the application, Victoria Police, VicRoads, the Department of Justice, the Sheriff’s Office, any other government department or agency, or other persons, and using, or disclosing that information to third parties, or the contact person for this application, for the purposes of the Act or as otherwise authorised by law. Warning: It is an offence under the Act to provide false or misleading information in this form. Applicant’s signatory or signatories 1. Name of signatory Role of signatory (see page 2) Signature Date 2. Name of signatory Role of signatory (see page 2) / / Signature Date 3. Name of signatory Role of signatory (see page 2) / / Signature Date Attach a separate sheet with further names, capacities, signatures and dates if necessary. Department of Transport Victorian Taxi Directorate, Level 23, 80 Collins Street, Melbourne VIC 3000 GPO Box 2797, Melbourne VIC 3001 Phone: 1800 638 802 (toll-free) www.taxi.vic.gov.au Authorised by the Victorian Government, 80 Collins Street Melbourne 3000. October 2012 / /
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