Florida Orlando Driver License Form in PDF

City of Orlando

DRIVER PERMIT APPLICATION

FULL NAME:_______________________________________________________________________________

LastFirstM.I.

STREET ADDRESS:__________________________________________________________________________

NumberStreetApt #

___________________________________________________________________________________________________

SEX: Male Female HAIR COLOR:________EYE COLOR:________HEIGHT:___Feet___Inches WEIGHT:______Lbs.

TELEPHONE # ________________________EMAIL ADDRESS:__________________________________

FLORIDA DRIVER’S LICENSE #:_________-_______-_____-_______-___EXPIRATION DATE:_____-_____-________

Any crime which is designated a felony?………………………………....……………………………………………………..

Any crime (felony or misdemeanor) involving the sale or possession of a controlled substance as defined by F.S.S.893?

Any crime (felony or misdemeanor) under Ch.796 of the Fl. Statutes, prostitution, including but not limited to assignation for prostitution and solicitation for prostitution, or with sections 43.17-43 of the Orlando City Code?……..

Any sex crime ?………………..………………………………………………………………………………………..………..

The Florida RICO Act (Florida Racketeering Influenced and Corruption Organization Act) ?….……………………….

Driving under the influence of drugs or intoxicating liquors (DUI)?….……………………………..………………………

Reckless driving?….…..….……………………………..………………………………………………………………….…….

IMPORTANT:If yes is checked to any of the above questions you may not be eligible for a City of Orlando Driver Permit. Please give date of arrest, charges and disposition of the case___________________________________________________

_______________________________________________________________________________________________________

FOR HIRE TRANSPORTATION COMPANY ENDORSEMENT

(TO BE COMPLETED BY FOR HIRE COMPANY PERMIT HOLDER) (PLEASE PRINT)

This is to certify that ___________________________ will be an authorized driver for _______________________________

(Print name of driver applicant)(Print name of For Hire company)

if he/she meets all the requirements of the Vehicle for Hire Section, and Chapter 55 of the City of Orlando Code.

Signature of authorized representative of For Hire company____________________________Date signed:____/____/_____

Print name of authorized representative of For Hire company:_________________________Phone #:_________________

Address of For Hire company:______________________________________________________________________________

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:___________________________________

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.

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