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NYC Taxi & Limousine Commission

 
 



 
     
Licenses | Medallion Owners & Agents

Driver Removal Form
Fields with an asterisk (*) are required for the completion of this form.
As the Leasing Agent or Owner for this medallion, I am requesting that the following named driver(s) be removed from the rate card. There is presently no contract or leasing agreement between the medallion owner and below listed driver(s).
*Medallion Number
*DRIVER LICENSE (HACK) #
*DRIVER NAME
#1
#2
#3
#4
#5
*Agent's or Owner's Name
*Agent's or Owner's License #
*Agent's or Owner's E-mail Address






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