Borough of Madison                     Phone: (973) 593-3042
Hartley Dodge Memorial                                        Fax: (973) 593-0125  50 Kings Road
Madison, NJ 07940

APPLICATION FOR TAXI OR LIVERY OWNERS LICENSE
(Applications accepted on or after November 1, expire December 31 in year of issue)

Date:                                                          

TO THE MAYOR AND COUNCIL OF THE BOROUGH OF MADISON:

In compliance with the provisions of Article 173 of the code of the Borough of Madison, amendments and supplements thereto, application is hereby respectfully made for:

Taxi owner’s license                                                               Annual fee: $25
                         (Taxi Owner’s Name)

OR,

Livery owner’s license                                                           Annual fee: $50
                          (Livery Owner’s Name)

Trade name:                                                                          

Make of car:                                                          Year:                                

Registration #                                               Expiration Date:                         

Address where car is garaged:                                                                     

Owner of property where car is garaged:                                                    

I hereby agree to conform in all particulars to the provisions and conditions of the aforesaid ordinance, including amendments and supplements, and such regulations and other ordinances as may be adopted by the Council from time to time.

Applicant’s signature:                                                                                       

Please return completed application to Borough Clerk’s Office with appropriate fee and Certificate of Insurance. Please arrange for vehicle inspection six months prior to expiration of vehicle’s registration by calling Traffic Safety Officer at (973) 593-3035.

For Use by Borough Clerk’s Office:

Fee paid: $25 Taxi Owner           $50 Livery Owner               
Power of attorney filed by owner:                                         
Certificate of Insurance filed (PL 100/300 PD 50), approved by Borough Attorney:         Inspected by Police Department six months prior to expiration of vehicle’s State Registration        
(Rev. 6/04)