Application to be licensed as a new driver Surname (Mr, Mrs, Miss, Ms) Maiden name All forenames Previous surnames/aliases Date of birth Place of birth
Sex: Male Female Current address
Postcode
Home telephone number Business telephone number Mobile number
National insurance number Email address:
How long have you been licensed to drive a motor vehicle?
This form should be completed and together with the appropriate fee and
supporting documentation submitted at one of the Herefordshire council customer service centres.
Previous addresses in the last 5 years (please list all including dates)
Please give names and addresses of present employer, if any, and particulars of
employment during the past 5 years (please include the dates and nature of employment)
Convictions/Cautions
You must declare ALL convictions or cautions you may have. The information you give will be treated in confidence and will only be taken into account in relation to your application. You should be aware that the Council is empowered in law to check with the DBS for the existence and content of any criminal record held in the name of an applicant. Information received from them will be kept in strict confidence and will be retained for no longer than is necessary.
The disclosure of a criminal record or other information will not bar you from gaining a licence unless the Council considers that the conviction renders you unsuitable. In making this decision the Council will consider the nature of the offence, how long ago and what age you were when it was committed and any other factors which may be relevant. Any
applicant refused a driver’s licence on the ground that he/she is not a fit and proper person to hold such a licence has a right of appeal to a Magistrates Court.
Conviction – please include all past convictions spend and unspent
Have you ever been convicted at a court for any offence under the terms of the rehabilitation of Offenders Act 1974?
Yes No (If yes, please complete the following)
Please give full details of the offence, date of offence, the court, date of conviction and the penalty
Caution
Have you ever been cautioned for an offence?
Yes No (if yes, please complete the following)
Please give full details of offence, date of caution and the name of the police force
Incidents which may lead to caution or conviction – these include pending investigations
Have you ever been involved in any incident, which may lead to court proceedings being taken against you?
Yes No ( if yes, please provide full details)
Have you undergone a previous DBS check by any other licensing authority or body during the last 12 months?
Yes No (you are not obliged to answer this question) Have you been convicted of any motoring offences
Yes No (if yes, please complete the following)
Please provide the full details including ‘convicting court code’, ‘date of conviction’, ‘offence’, ‘date of offence’, ‘fine’, ‘disqualification period’ and ‘penalty points’
Have you previously been licensed to drive a private hire/hackney carriage vehicle? Yes No (if yes, please complete the following)
Name of council
Type of licence
Period when licence held
Have any licences in respect of Private Hire or Hackney Carriage held by you ever been revoked, suspended or refused?
Yes No
If yes, please supply details (including name of authority)
THEFT ACT 1968 SECTION 16
It is an offence under the Act to obtain a pecuniary advantage. If the application form is not filled in correctly i.e. failure to indicate any convictions subject to the Rehabilitation of
Offenders Act 1974, you will have been deemed to have committed an offence and the matter may be referred to the Police. (see notes on last page)
To be completed by the vehicle proprietor
Have you satisfied yourself that the applicant is a fit and proper person to be employed in this capacity?
Yes No
Have you satisfied yourself that the applicant has a good knowledge of the area? Yes No
Have you informed the applicant of the basics of the law relating to the service? Yes No
Does your vehicle insurance cover include the applicant (copy to be forwarded with application)
Signature of vehicle proprietor……….. Date:………..
Print name of vehicle proprietor……….. Name of company/group for which vehicle operates
Address from which company/group operates
To be completed by the applicant
I certify that the above answers are true and understand that if there are any omissions or false statements, my application will be refused or if a licence has been issued, it will be liable to immediate suspension or revocation.
I am aware that the grant of such a licence is subject to a criminal record check. This has been explained to me and I understand that the licensing authority does consider spent convictions. I hereby declare that the information given above is true.
I enclose the following:
1. Valid driving licence (if photo card format we require both paper and card parts) 2. My birth certificate / passport
3. Copy of the insurance certificate for the vehicle I will be driving
I agree that information in relation to my application may be shared with other directorates within Herefordshire Council.
Signature……….. Date………..
Data Protection Act 1998
This policy covers the treatment of personal data that Herefordshire Council may collect when you e-mail us, complete an application form, or when you complete and submit an online form on our web site.
When completing forms you may be asked for personal information such as name, address, postcode etc. It is only when you supply this type of information that you can be personally identified.
Herefordshire Council is registered with the Data Protection Act 1998 for the purpose of processing personal data in the performance of its legitimate business. Any information held
Where necessary we may share this personal data with partner organisations e.g. for the protection of public funds administered which may include the prevention or detection of fraud and auditing purposes.
Further information relating to the Data Protection Act 1998 can be sent to you on request. If you have concerns about the processing of your personal data by the Council you may contact the Council’s Data Protection Officer:
Data Protection Officer, County Secretary and Solicitor, Herefordshire Council Herefordshire Council
Plough Lane Hereford Herefordshire HR4 0LE
THEFT ACT 1968 SECTION 16
It is an offence under the Act to obtain a pecuniary advantage. If the application form is not filled in correctly i.e. failure to indicate any convictions subject to the Rehabilitation of
Offenders Act 1974, you will have been deemed to have committed an offence and the matter may be referred to the Police.
Definitions of convictions:- Rehabilitation Periods
SENTENCE AGE 18 OR OVER UNDER 18
WHEN CONVICTED WHEN CONVICTED
Prison and Young Offender Institution – 7 years 3 years Sentence if 6 months or less
Prison and Young Offender Institution - 10 years 5 years Sentence of more than 6 months – 2½ years
Fines, compensation order, probation (for People convicted on or after 3rd February
1995), community service, combination 5 years 2 years order, action plan, curfew order, drug
treatment, reparation order
Sentence AGE 18 OR OVER UNDER 18
WHEN CONVICTED WHEN CONVICTED
Borstal (abolished 1083) 7 years 7 years
Detention centre 3 years 3 years
Absolute discharge 6 months 6 months
Sentences for which the rehabilitation period varies: Probation order (for people convicted prior
To 3 February 1995), conditional discharge, Until the order expires (minimum period of 1 year)
Bind over, supervision order, care order
Attendance centre orders length of the order plus 1 year
Hospital order 2 years after the order expires (with a minimum of
5 years from the date of conviction)
Suspended sentences
A suspended prison sentence is treated as one that has taken effect and the rehabilitation period is the same as for the full sentence.
