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Taxi Driver Permit Application

Use this form to apply for a City of Cold Lake Taxi Driver permit. The application fee is $70.00. Payment details are entered on the following page.

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Freedom of Information and Protection of Privacy Act, Sec. 33 (c) which regulates the collection, use and disclosure of personal information.

Part 1: Applicant Information

Name (first and last)

Date of birth

Place of birth (if born outside Canada)

Primary Phone Number

Email address

Mailing address

Residency address (if different than mailing address)

Part 2: Previous addresses

List all residences in the past three (3) years

Part 3: Driver's license and employer information

Alberta driver's license number

Alberta driver's license expiry

Employer (taxi company) name

Employer mailing address

Part 4: Application checklist

Attach the following supporting documents:

One (1) photo measuring 1 1/2" high and 1 3/8" wide (can be mailed or dropped off at City Hall)
One (1) copy of RCMP issued Criminal Record Check
One (1) copy of driver's abstract (available at Tri-Town Registries)
One (1) copy of Class 4 driver's license
One (1) letter of employment from applicant's employer (taxi company)

Attach supporting documents

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Part 5: Signature

I certify that the information provided on this application is true to the best of my knowledge. I have read the City of Cold Lake Taxi Bylaw No. 760-Pl-22, and believe that I am eligible to hold a taxi driver permit in accordance with section 5 of the Taxi Bylaw. I acknowledge that by typing my name below, I am signing this application and I agree to be bound as if I had endorsed this document with my own handwritten signature.

Name

Date

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATIA Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.