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Vehicle for Hire Broker License Application

Broker Type:

General (Taxicab, Limousine)

Transportation Network Company Broker (Private Vehicle for Hire)

Please select the license fee that applies to this application below. Please note all licenses expire March 31.

General Broker License - $216.30

Transportation Network Company Broker 1-15 vehicles - $200.00

Transportation Network Company Broker 16 - 30 vehicles - $500.00

Transportation Network Company Broker 31 or more vehicles - $1000.00

Name of Brokerage:

If yes, please supply a copy of the Letters of Incorporation / Master Business License Here

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If you are a Transportation Network Company Broker, please attach proof of insurance indemnifying and protecting the Driver, TNC Broker and the public, including Passengers, in the amount of $2,000,000.00.

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Applicant Information

Applicant Name:

Street Address:

City/Town:

Province:

Postal Code:

Telephone Number:

Email:

Broker Office Address:

Please provide proof of system for receiving orders and dispatching vehicles here.

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How many vehicles are expected to operate with this brokerage?

Applicant Acknowledgement and Signature

If you are applying as a corporation, please include the full name, address and telephone number of each Officer and Director below.

If you are applying as a partnership, please include the full name, address and telephone number of each partner below and details of each partner’s interest in the partnership

I understand and attest to the information provided on this application to be true and accurate. I understand that the County relies on this information and by signing this document, I solemnly declare that the information contained on this application is true, and I make this solemn declaration conscientiously believing it to be true, and knowing that it is the same force and effect as if made under oath.

Applicant Signature:

Clear

Partnership Signatures (In the case of a Partnership, all partners are required to sign this application)

Clear

Today's Date:

Personal information collection is necessary for administration of County of Brant By-law #58-22 Vehicle for Hire By-law authorized by the Municipal Act, 2001, S.O. 2001, c. Personal information collected is managed under the provisions of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M. 56, as amended, and will be used for the purpose of processing your application.

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Vehicle for Hire Broker License Application

Applicant Information

Applicant Acknowledgement and Signature