APPLICATION FOR ENTRY INTO A BALLOT OF DEFINED RIGHTS FOR RESTRICTED TAXI LICENCES FOR WHEELCHAIR ACCESSIBLE TAXIS
13 MAY 2015

 Section 84G of the Road Transport (Public Passenger Services) Regulation 2002

TO BE COMPLETED BY APPLICANT

SURNAME(S) /COMPANY NAME		

GIVEN NAME(S)		

EMAIL ADDRESS		

RESIDENTIAL ADDRESS		

PHONE NUMBER (B/H)		

MOBILE PHONE NUMBER		

TAXI SERVICE OPERATOR ACCREDITATION NUMBER (IF APPLICABLE)		

AN INDIVIDUAL OR A COMPANY MAY MAKE ONLY ONE (1) APPLICATION.  

•	AN APPLICATION FEE OF $25.00 IS REQUIRED, PAYMENT MAY BE BY CHEQUE OR MONEY ORDER.	
•	INDIVIDUAL APPLICANTS MUST PROVIDE PROOF OF IDENTIFICATION, IE LICENCE & PASSPORT (if applicable)	
•	FOR COMPANIES AN ASIC CERTIFICATE OF REGISTRATION IS REQUIRED	
		
THE COMPLETED APPLICATION AND ID DOCUMENTATION MUST BE SUBMITTED IN PERSON BY 
THE APPLICANT/S, BETWEEN 8:30AM AND 4:00PM TO:

	THE ROAD TRANSPORT AUTHORITY – Public Transport Regulation
LEVEL 2
	DICKSON MOTOR VEHICLE REGISTRY
	13-15 CHALLIS STREET
	DICKSON  ACT  2602

NOTE: The Road Transport Authority may require an applicant to provide further information or documents needed to decide the application.

APPLICATIONS CLOSE 4 MAY 2015 AT 2:00PM

        IDENTIFICATION/CERTIFICATE OF REGISTRATION ATTACHED                PAYMENT ATTACHED  

STATEMENT OF SUPPORT FOR ENTRY INTO A
BALLOT OF DEFINED RIGHTS FOR RESTRICTED TAXI LICENCES
FOR WHEELCHAIR ACCESSIBLE TAXIS

I have the following demonstrated experience working with people with disabilities (provide relevant details)	

	

	

	

	

DECLARATION

NOTE:  Applicants may be interviewed prior to their application being accepted for the Ballot.  At the interview applicants may be required to address a series of questions relating to the provision of wheelchair accessible taxi services.  Applicants may also wish to provide references.

I declare that the information provided in this application is true and correct.  I hereby apply for entry into the ballot of defined rights for a restricted taxi licence.

SIGNATURE_________________________________________	DATE__________________	

APPLICATION FOR ENTRY INTO A BALLOT OF DEFINED RIGHTS FOR RESTRICTED TAXI LICENCES FOR 
WHEELCHAIR ACCESSIBLE TAXIS 

13 MAY 2015

APPLICANT CHECKLIST

I have read and understand the document “Ballot of Defined Rights for a Restricted Taxi Licence for Wheelchair Accessible Taxis, 13 May 2015, Information Sheet”.
I have read and understand the documents – Road Transport (Public Passenger Services) (Conditions for a Ballot of Defined Rights) Determination 2015 (No 1) and Road Transport (Public Passenger Services) (Defined Right conditions) Determination 2015 (No 1).
I understand that a restricted taxi licence is issued subject to the condition that the licence holder must NOT transfer or sub-lease the licence to anyone else.
I understand that the holder of a Wheelchair Accessible Taxi Licence must ensure that priority for the hiring of the taxi is given to wheelchair-dependant people.
I understand that the Road Transport Authority may change the regulatory regime and policies relating to the management of wheelchair accessible taxi licences at any time within the 6 year licence period.
I understand that I must be the main driver of the taxi to which the defined right relates.
I have made one application only to enter this ballot.
I do not operate more than one other taxi.
I am 20 years of age or older.
I have provided my original birth certificate, passport or driver licence confirming my
identity, (for an individual) and for a company a photocopy of an ASIC Certificate of Registration certifying the name and ACN of the company.

I am aware that I may be required to attend an interview with the RTA.

For enquiries, please contact the Road Transport Authority on 6207 1423 or 6207 7159