Transport Licensing Forms




3500

THE NEW ZEALAND GAZETTE.

[No. 94

“ (c) A temporary license-meaning thereby a license for a service to be carried
on for a specified period of not more than seven days or a license for any
specified special occasion or occasions;” (e.g., exhibitions, special
sporting events, &c.).

[For Receiver's use only.]

Date receipt stamp:

To be placed before Licensing Authority.
Serial number:
Receiver's Fee Receipt No.:
Acknowledged and receipt sent:
Position re Certificates of Fitness is

[Initials and date] , 193

[BACk OF FORM.]

Schedule of Vehicles.

Current Make and Capacity. Class of Heavy- Date Give Particulars
Registration- Model (if any Seating. traffic License, Certificate of of any other Route
plate No. are Six-wheelers, Standing. if any, (Class Fitness has or Routes on
(on License state so). A, B, C, &c.). been or will which the Vehicle
Plate). be applied for. is used or proposed
to be used.

Sketch-plan of route (if plan not attached).

Form B.

[Note.—A bank receipt must accompany this application, showing that there has
been paid in respect of it into the Public Account to the credit of the Consolidated Fund
a fee of £3 if the vehicle is to be used in a licensed passenger-service or a fee of £2 if it
is not to be so used.]

APPLICATION FOR CERTIFICATE OF FITNESS IN RESPECT OF A PASSENGER-SERVICE
VEHICLE. [To be supplied in triplicate.]

[Attention is directed to the fact that if any of the information supplied is false or misleading it renders the applicant liable to a fine up to £10.]

The District , Department, at .

I hereby apply for a Certificate of Fitness in respect of the motor-vehicle,
particulars of which are given below, with a view to operating it in the service and
over the routes specified hereunder.

Name of registered owner:
Business Address:
Garaged regularly at:
Current registration-plate No.:
Last year's registration-plate No.:
Vehicle fleet No.:
The {certificate of fitness} last issued expires on [Date].
permit
Date when vehicle was first used:
Make of chassis:
Model, type, and class reference:
Engine No.:
Chassis No.:
Wheel-base:
Tires (number on each axle, kind and size):

Chassis-maker's Rating, as per Specification or Data Plate.

Net standard chassis weight (lb.):
Maker's maximum safe load on chassis (lb.):
Ordinary body-allowance (lb.):
Ordinary seated-passenger capacity: ; or, if commercial type chassis,
payload (lb.)
Maker's recommended gross running-weight of vehicle {(a) Laden (lb.):}
(b) Unladen (lb.):
Any other available data (gear ratio, engine rating, &c.):
Actual tare weight of finished vehicle in running-order and fully equipped, excluding
driver (lb.):
State whether or not chassis is standard, and, if any alterations or additions have
been made, describe them; and, if possible, state the resultant added or reduced weight
of the chassis, as the case may be:
Number of passengers for which certificate will be sought: seated;
standing.

Estimated maximum total weight of {(a) Passengers' luggage lb. (averaged
at 7lb. per passenger, or more in
special circumstances).
(b) Goods: lb.

Application for a passenger-service license was {made by me to
granted to me by} the
{Commissioner of Transport, } on [Date.]
Licensing Authority }
Is the vehicle proposed to be used on all your licensed routes:
If so, state limitations:

Dated at , this day of , 193 .



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🚂 Application Form for Passenger-Service License (continued from previous page)

🚂 Transport & Communications
Application, Passenger-service license, Temporary license, Vehicle schedule, Certificate of Fitness

🚂 Application for Certificate of Fitness for Passenger-Service Vehicle

🚂 Transport & Communications
Certificate of Fitness, Vehicle registration, Passenger-service vehicle, Application form