Licensing Unit Room 1012 (Level 1) Town Hall Extension Manchester M60 2LA Tel: 0161 234 4917

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Request to Obtain Stickers for Private Hire Vehicle

1. Stickers are issued free of charge for vehicles newly plated. 2. Replacement stickers are available at a cost of 10 per set. 3. This form should be presented when collecting plates at Gorton Test Centre. 4. Stickers will not be issued without this form fully completed and stamped. Vehicle Registration Name of Vehicle Owner (print) Signature of Vehicle Owner Name of Operator Base Address of Operator Base Plate No.

Authorised By: (print name) Job Title Signature of authorisation Date:

Base Stamp (must be provided):

Office Use Only Date Stickers Issued

Issued by:

H:\RegulatoryServices\Licensing\MASTER DOCS\Private Hire\PH Vehicle application forms\PHV New Apps\sticker-request.doc