
DRIVER APPLICANT CERTIFICATION (TO BE COMPLETED AT VEHICLE FOR HIRE OFFICE)
Any person having been denied a City of Orlando Driver’s Permit under this section, may appeal said denial to the City of
Orlando Vehicle for Hire Appeals Board by complying with the requirements of Chapter 55.29 (5a).
I understand that my Driver’s Permit may be subject to suspension or revocation by the Vehicle for Hire Administrator
or his/her designee under, but not limited to the following conditions:
1. If I fail to comply with or willfully violate any of the applicable provisions of the City of Orlando Code and/or the
applicable laws.
2. If any material fact was omitted, misrepresented or falsely stated on my application.
3. If I fail to notify the Vehicle for Hire Section in writing within thirty (30) working days of any change in name,
address, phone number, driver license, employer etc. while my Driver’s Permit is valid.
I understand that my Driver’s Permit shall be automatically revoked by the Vehicle for Hire Administrator or his/her
designee:
1. If I plead nolo contendere, plead guilty or am convicted of a felony or of any criminal offense involving moral
turpitude or a crime involving the use of deadly weapons or trafficking narcotics;
2. If my State of Florida Driver’s License is suspended or revoked;
3. If it is determined, after drug or alcohol testing, that my use of alcohol or a controlled substance has impaired or is
impairing my ability to drive a for hire vehicle.
I understand that fines, as required by the City of Orlando Code for each infraction, may be imposed for violation of
Code provisions. Furthermore, I understand that the intentional inclusion of false information on this application may
subject me to prosecution for violation of the City Code Section 43.16 and penalties of up to sixty (60) days imprison-
ment and/or $500.00 fine.
I have read and understand the above. I agree to carry out my Driver duties accordingly.
I certify under oath that I am not a user of alcohol or drugs whose current use would constitute a direct threat to
property or the safety of others. I further pledge that I will not be a user of alcohol or drugs in a manner that would
constitute a direct threat to the property and safety of others. I further certify under oath that I am free of any mental
defect or disease that would constitute a direct threat to the property or safety of others or would impair my ability to
drive a for hire vehicle. This further certifies that I am duly authorized to work in the United States of America under
the current laws of the Department of Homeland Security, Bureau of Citizenship and Immigration Services.
I also certify that all statements contained in my application are complete and true. I acknowledge that omissions or
false statements will be grounds for revocation or non-issuance of a City of Orlando Driver’s Permit.
Driver Applicant Signature:_____________________________________ Date:___________________________________
VEHICLE FOR HIRE OFFICE USE ONLY .
PERMIT ISSUED: YES NO ORIGINAL RENEWAL DUPLICATE TEMPORARY
PERMIT #____________ ISSUE DATE: ____/____/________ EXPIRATION DATE: ____/____/________
PROCESSED BY:_____________________________________ INVOICE #_____________
PERMIT DENIED (STATE REASON):____________________________________________________________
DATE/COMPANY REPRESENTATIVE NOTIFIED OF DENIAL:____/____/____ _____________________
Notice: There is a
NON-REFUNDABLE application and permit fee due and payable at the time this application is filed. Payment options may
include a check, money order, debit or credit card. Cash will not be accepted.
Msw(P;)v4hire/vfh/forms/drivappl07