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Taxi Cab Driver Application

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Step One

Taxi Cab Driver Application
License Code (49)
Burlington City Ordinance 1083*
1. Fee $50
Application fee is non-refundable
For Office Use: License Number
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Please Print and Write Legibly

Name*
Complete Mailing Address (State & Zip Code)*
Telephone Number*
Date of Birth*
Place of Birth*
Name of Employment*
Address of Employment*
Have you ever had a driver’s license revoked or suspended?*
1. Yes
1. No
If yes, please say why:
List any prior convictions of felony offense in the past ten years or any misdemeanor involving immoral conduct, theft, assault, or traffic infraction in the past five years: *
The City of Burlington reserves the right to require licensee to take a driving test as determined by the Chief of Police.
For Office Use Only
To be Completed By the Chief of Police
1. Approved
2. Disapproved
Comments
Signature of Chief of Police*
Date*
City Hall
Email: bjohnson@ci.burlington.wa.us

833 S. Spruce Street
Burlington, WA 98233-2810

Ph: 360-755-0531
Fx: 360-755-9565

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833 S. Spruce Street, Burlington, WA 98233
Phone: 360-755-0531

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