HomeMy WebLinkAboutDecal APP 2018Office Use Only
DECAL #
DATE ISSUED:
DATE RETURNED: ___________
APPLICATION FOR TAXI DECAL
Fee $ 85.00 Vehicles older than 10 years
Fee: $35.00 vehicles 10 years old or less
Appointment for vehicle inspection must be made between 8 a.m. and
Noon, Monday thru Friday with Dan or Darwin at 887-6122
1. Business Name
2. Vehicle Information:
Year: Check appropriate designation ______ older than 10 years.
______ 10 years old or less
Example: during the calendar year 2018, the model must be 2008 or newer to qualify for $35.00 fee.
Year: ______
Make of Vehicle:
Serial Number:
3. Certificate of insurance for this taxi
(policy must cover the license period and show a deductible not to exceed $500, with cancellation
endorsement)
4. Original of vehicle Inspection.
5. Completed Taximeter Certification form must be attached for metered taxi only.
I understand that if I falsely answer any of the questions in this application, that this application will be
denied. I agree that in making this application, I consent to allow agents or employees of the City of Iowa
City, Iowa, in their discretion, to examine any and all records and documents relating to this application,
and I further agree that, if a license is granted, to comply at all times with all of the provisions of Title 5,
Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public)
Signature ___________________________________________________________________________ Owner/Authorized individual (name must be listed on application or authorized statement, respectively)
Owner/Authorized individual (name must be listed on application or authorized
statement, respectively) respectively)
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STATE OF IOWA )
COUNTY OF JOHNSON )
Subscribed and sworn to before me by ____________________________________. On this ___________ day of
_____________________________________.
________________________________________
Notary Public in and for the State of Iowa
DECALS WILL BE ISSUED 24 HOURS AFTER COMPLETED APPLICATION RECEIVED BY THE CITY CLERK
Clerk/DecalApp 2018.doc 6/2016