TFH Company Application

1. Applicant

2. Ownership

3. Drivers

4. Vehicles

5. Declarations

6. Signature

TRANSPORTATION REGULATION APPLICATION

Basic applicant details, service type, business type, fleet size, and passenger capacity.

Any false or misleading information entered on this application shall be cause for denial of this application, or revocation of the permit if discovered after issuance.

Type of Service

Applicant Name

Texas Driver License #

Social Security Number

Race

Sex

Date of Birth

Home Telephone

Home Address

City

State

Zip

Legal / Corporation Name

DBA / Trade Name

Form of Business

Business Address

Business City

Business State

Business Zip

Mailing Address

Business Phone

Business Fax

Email Address

Fleet Size

Passenger Capacity

Are you under indictment, on probation, or in the last five (5) years, have you been convicted or released from confinement imposed for conviction for a crime involving criminal homicide, kidnapping, a sexual offense, assaultive offense, robbery, burglary, theft, fraud, tampering with government documents, public indecency, prostitution, obscenity, carrying or possession of a weapon, driving while intoxicated, violation of the Dangerous Drugs Act, violation of the Controlled Substances Act, or a criminal attempt to commit any of these offenses?

Yes No

Ownership & Authorization

Outstanding warrants, website, authorized signers, and owners/shareholders.

Are there any outstanding warrants of arrest against you?

YES (explain) NO

Website:

Name and signature of individual(s) authorized to sign other than applicant: (PLEASE PRINT)

Authorized Signers

Owners / Shareholders

Drivers

Add all drivers that will be listed under this application.

Driver List

Vehicles

Add all vehicles to be used in the service.

Vehicle List

Declarations

As owner of the service listed above, I certify that:

Applicant acknowledgements and certifications.

I hereby authorize procurement of consumer report(s) by the City of Dallas. I authorize without reservation, any person, business, or agency contacted by the consumer reporting agency to furnish the attached information. I certify that I have read the Disclosure for Consumer Reports document and understand that I have rights under the Fair Credit Reporting Act, and I acknowledge receipt of the Summary of Rights. I certify that I have read the City of Dallas Chapter 47A Driver Training material, including the rules and regulations for transportation-for-hire drivers. I authorize procurement of consumer reports by the City of Dallas. I have read the Disclosure for Consumer Reports and understand my rights. I have read the Chapter 47A driver training material and regulations.

Signature & Notary Section

Final applicant confirmation. You can keep the notary section for admin-side completion if needed.

Signature of Applicant(s)

Date:

County Of

State

Notary Name

Commission Expires

Notary Date

Tip: if the notary fields should not be visible to the user, you can remove them from the frontend and complete them in wp-admin later.

TFH Company Application

TRANSPORTATION REGULATION APPLICATION

Ownership & Authorization

Authorized Signers

Owners / Shareholders

Drivers

Driver List

Vehicles

Vehicle List

Declarations

Signature & Notary Section

TFH Company Application

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