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«APPLICATION TO PURCHASE A NON-WHEELCHAIR STREET HAIL LIVERY PERMIT Please visit our website for more information at: or our office ...»

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“I hereby affirm, under penalty of law, that I have examined and reviewed the information in the submitted form(s) or application(s), including any supplemental form(s) and/ or document(s) and that these document(s) and or statement(s) do not contain any untrue statement(s) nor are they missing any material information and/ or fact(s) according to the rules applicable to my license type. There have been no changes to the Business Entity structure for the most current & existing license since the last submission to the TLC, if applicable. I also acknowledge and understand that any false statement(s) submitted is punishable under the law and may result in a denial of an application or the suspension or revocation of an existing license/permit. I affirm that the Workers’ Compensation Policy being submitted as proof of coverage contains no exclusions as to service type (street hail or dispatch) and that the policy provided provides full coverage for both street hail and dispatch services. In addition, I affirm my understanding that I will be granted only one (1) extension per permit to place my vehicle in service past the in service date. Said single extension will be limited to a maximum of thirty (30) days only. I understand that no further extensions will be granted and that my permit is subject to revocation if I do not have a vehicle in service by the required date.

I further affirm and acknowledge that I have read all rules applicable to my license and that I understand that I am are required to follow and comply with these rules. Failure to do so may result in the issuance of a summons that could result in the imposition of points, fines, a suspension or revocation of my license.”

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If this is base transfer and not a first time affiliation, a $25.00 payment is required.

SHL Permit Holder Name D/B/A Mailing Address

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Base / Authority Name:

Base License #:

OLD BASE/AUTHORITY INFORMATION (complete this section if this is an application to Transfer to another Base)

Base / Authority Name:

Base License #:

“I hereby affirm, under penalty of law, that I have examined and reviewed the information in the submitted form(s) or application(s), including any supplemental form(s) and/ or document(s) and that these document(s) and or statement(s) do not contain any untrue statement(s) nor are they missing any material information and/ or fact(s). There has been no changes to the Business Entity structure since the last submission to the TLC if applicable. I also acknowledge and understand that any false statement(s) submitted is punishable under the law and may result in a denial of an application or the suspension or revocation of an existing license/permit. I also attest that all my vehicles attached to my SHL Permit must be attached to the same SHL base.” This section must be signed and dated by the Base Owner.

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-Per TLC Rule §82-44, the following requirements apply to all SHL permit transfers:

Commission Approval: No permit transfers can take place without the written approval of the Commission.

Documents: An Applicant must submit a fully completed SHL Permit Transfer Application along with all supporting documentation required by the Commission. Please visit our website at: www.nyc.gov/tlc/shl for additional information on the SHL program. You can download the

Transfer application, Requirements and Checklist document off of our web site at:

http:// www.nyc.gov/html/tlc/downloads/pdf/shl_permit_transfer_app_and_checklist.pdf.

Attendance Required: All parties involved in the transfer must appear before the Commission.

You may schedule a closing for the sale of your permit by contacting our Legal Department at 212-676-1135.

Fulfillment of the Licensing Requirements: The entity purchasing the SHL Permit must meet all required SHL Licensing requirements at the time of the purchase. This includes, but is not limited to, the requirement that you be a licensed TLC FHV driver or hold an FHV vehicle owner license for at least one year and that the license is in good standing with the TLC. Ownership limitations apply at all times and you cannot hold or have an interest in more than the allowable number of permits under the law (one non-wheelchair accessible permit and ownership interests in up to five wheelchair accessible permits).

No person or entity is permitted to attempt to transfer or participate in the transfer of any SHL permit without contacting TLC Legal prior to the sale.

Violations of this process and attempts of invalid transfers will result in a $10,000 fine and possible revocation of your permit.

I, ____________________________________, (business entity representative for the business entity purchasing the (Print Name) permit\sole proprietor\officer\principle) acknowledge my\our understanding that the entity purchasing this permit cannot proceed with any sale or transfer of said permit unless I\we fully comply with all TLC sale\transfer requirements. By my signature below I affirm my understanding of these requirements and of the above.

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