Required fields are marked with asterisks (*)

City of Belleville

By-Law 2022-079 - Application Form

Driver Licence #:
Approved By:
Date Received:

Please select

Taxi Driver

Limousine Driver

TNC Driver

New

Renewal

First Name

Last Name

Mailing Address

Postal Code

Telephone Number

Email Address

Have you been a driver in another municipality?

Yes

Company you are employed with