In navigating the procedural waters of professional licensing, the DCA License Renewal form stands as a critical document for taxicab drivers within the County of Broome. As dictated by Section 85-9 of the Local Law of the County of Broome, this form mandates applicants to renew their licenses at least thirty days before expiration to avoid the more rigorous and costly process reserved for new applicants. The form itself collects essential information, including personal details, employment history, and any legal infractions, underscoring the thorough vetting process for continued eligibility. Additionally, it requires applicants to undergo a drug screening test and have their New York State Chauffer’s License and driving history reviewed, further ensuring that only qualified individuals are permitted to maintain their status as licensed taxicab drivers. This comprehensive approach reflects a commitment to public safety and professional standards, as making false statements in this application is a crime punishable as a Class A misdemeanor. Thus, the application process for renewal serves not only as a procedural step but also as a reinforcement of legal and ethical accountability for drivers.
| Question | Answer |
|---|---|
| Form Name | Dca License Renewal Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | taxi permit renewal, shall broome renewal, drivers license template editable word, dca renewal application |
APPLICATION FOR RENEWAL OF TAXICAB DRIVER’S LICENSE
Pursuant to Section
“Application for License Renewal shall be made at least thirty (30) days prior to its expiration on this form. Applications submitted less than 30 days prior to the expiration date of same shall be treated as a new application and shall be subject to the requirements and fees applicable to same. (Sections
Attach additional documentation as necessary.
I the undersigned do hereby make application for renewal of my license to drive a taxicab within the County of Broome, pursuant to the relevant provisions of the Local Law of the County of Broome and any amendments thereto:
Last Name:__________________________ First Name: _________________ M.I.: ___
Date of Birth (mm/dd/yy):______________ NYS Chauffer’s License # ______________
Home Address: _________________________________________________________
Name & Address of Current Employer : ______________________________________
______________________________________________________________________
Date Original Taxi Driver License Granted (mm/dd/yy): __________________
License Number: __________________________ Expires(mm/dd/yy):
Since date of original taxi application, have you been arrested or convicted of a felony, misdemeanor, DWI or illegal drug charge?
Yes |
No If yes, explain: |
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______________________________________________________________________
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APPLICANT MUST REPORT FOR A DRUG SCREENING TEST ON
THE DATE OF THIS SUBMISSION.
APPLICANT SHALL ALSO BE SUBJECT TO REVIEW OF HIS NEW YORK STATE
DEPARTMENT OF MOTOR VEHICLES DRIVER’S LICENSE ABSTRACT
AND ANY CRIMINAL HISTORY
ATTACH COPY OF CURRENT TAXI DRIVER’S LICENSE
APPLICATIONS FOR RENEWAL SUBMITTED LESS THAN 30 DAYS PRIOR TO THE
EXPIRATION DATE SHALL BE TREATED AS A NEW APPLICATION
“PURSUANT TO THE NEW YOUR STATE PENAL LAW SEC. 210.45, IT IS A CRIME PUNISHABLE AS A CLASS A MISDEMEANOR TO KNOWINGLY MAKE A FALSE STATEMENT HEREIN”
Applicant Signature:
Date: (mm/dd/yy)
,being duly sworn, deposes and says that he/she is the
individual making the foregoing application for a taxicab driver’s license; and that the answers to the foregoing questions and other statements contained therein are true of his/her own knowledge and belief.
Subscribed to and sworn to before me |
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__________________________________ |
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Notary public or Clerk of Broome County |
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FOR OFFICE USE ONLY |
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Taxi Driver License #: |
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Expires(mm/dd/yy): |
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Copy of current Broome County Taxi Driver’s License attached |
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Copy of NY State Chauffer’s License |
Expires(mm/dd/yy): |
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DMV Driver’s License Abstract Attached |
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Criminal Records Check completed & attached |
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Drug Screening |
Positive |
Negative |
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Fee collected ($ 60.00) Cash |
Check |
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Check # |
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Processed by |
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Date (mm/dd/yy): |
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Approved
ATTACH ALL SUPPORTING DOCUMENTATION
Denied Reason:
__________________________________________ Date (mm/dd/yy):
Director of Security