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FIRST NAME *

LAST NAME *

PHONE NUMBER *

EMAIL *

DOB *

Address *

Line 1

Line 2

City

State

Zip Code

Country

MAKE AND MODEL OF VEHICLE *

YEAR OF YOUR VEHICLE *

HOW MANY PASSENGERS CAN YOUR CAR HOLD *

VIN NUMBER *

UPLOAD DRIVERS LICENSE *

Max file size: 20MB

WHAT COLOR IS YOUR CAR *

LICENSE PLATE NUMBER *

UPLOAD CAR INSURANCE *

Max file size: 20MB

UPLOAD CAR *

Max file size: 20MB

UPLOAD INSIDE CAR *

Max file size: 20MB

UPLOAD LICENSE PLATE TAG *

Max file size: 20MB

PLEASE PROVIDE A CLEAR HEADSHOT OF YOURSELF *

Max file size: 20MB

united taxi services is not rresponsible for any car repairs or any losses going into this position you understand that you are a independent contractor and you are responsible for all taxes for the services you provide if you understand please provide a signature below *

YES I AGREE AND UNDERSTAND I DONT AGREE

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DATE OF APPLICATION *

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