DFHV Form: NDL New Application | dc taxi

DFHV Form: NDL New Application

Applicant/Company Information

Applicant/Company Name *

Phone*

Email*

Street Address*

City*

State*

Postal Code*

Social Security Number(SSN)
Please enter either Social Security Number or EIN.

EIN
Please enter either Social Security Number or EIN.

Certificate of Clean Hands Notice Number*

Limo Authority License State*

Select State Limo Authority License *

Authority Expiration Date *
[ 7/22/2025 ]

State Limo Authority License Number*

Certificate of Clean Hands Issue Date*

Preferred Language*

State Limo Authority License*

Certificate of Clean Hands*

Tax Registration*

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