AFFIRMATION TO REQUEST A REPLACEMENT …
AFFIRMATION TO REQUEST A REPLACEMENT CREDENTIALI state, to the best of my knowledge, that no other person or business has any right to the lost or stolen Medallion/SHL permit and/or rate card reported here. Applicable to Medallion/SHL/RatecardApplicable to TLC Driver LicenseeI understand that by receiving a REPLACEMENT license that my original license will no longer be valid and if I am found operating with my original license, I will be subject to a fine, suspension, and/or , ___________________________________ , whose TLC license or credential number is: (Print Last Name, First Name)FHV DECAL ______________MEDALLION RATE CARD_____________TLC DRIVER LICENSE______________MEDALLION TIN _____________(Please check all that apply)LOSTSTOLENAffirmation- REQUEST for REPLACEMENT Credentials to the best of my knowledge, was(Please check one)This statement is provided to the Taxi a
AFFIRMATION TO REQUEST A REPLACEMENT CREDENTIAL I state, to the best of my knowledge, that no other person or business has any right to the lost or stolen Medallion/SHL permit
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