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Taxicab Rental Inquiry Form
This is NOT an employment application. You will be responsible for the operation of the taxicab you rent and the profits and losses you sustain. If you desire to rent a vehicle for a flat fee from a cab owner to operate the vehicle as an independent contractor, please complete the information required below.
 
St. Louis County Cab Company, Inc., Yellow Cab of St. Louis | 9930 Meeks Blvd. | St. Louis, MO 63132
Phone: 314-991-5544 | Fax: 314-991-4811 | countycab.com
*Indicates a required field.
 
First Name:* 
First name is required.
Middle Name:* 
First name is required.
Last Name:* 
Last name is required.
Address:* 
Address is required.
City:* 
City is required.
State:* 
State is required.
Zip:*
Zip code is required.Invalid format.
 
Primary Phone:* 
Phone number is required.Please enter as xxx-xxx-xxxx.
*Is this a Cell Phone?  
Please select Yes or No.
Cell Carrier: 
Secondary Phone: Invalid format. Is this a Cell Phone?  
Cell Carrier: 


Email address is required.Invalid email format.


Driver’s License # is required.


Driver’s License class is required.


Expiration Date is required.Please enter as mm-dd-yy.

Have you been involved in any automobile accidents in the last 3 years?*     
Select Yes or No
How Many?
 

Invalid format. Enter as mm-dd-yy.
 

Invalid format. Enter as mm-dd-yy.

PROFESSIONAL DRIVING EXPERIENCE
If Applicable
 

Enter as mm-dd-yy.

Enter as mm-dd-yy.

Enter as xxx-xxx-xxxx

Enter as mm-dd-yy.

Enter as mm-dd-yy.

Enter as xxx-xxx-xxxx.

 
IN SIGNING THIS INQUIRY FORM ON THIS DATE,
I DO HEREBY ACKNOWLEDGE THE FOLLOWING AND FULLY UNDERSTAND IT:
  • The information in this Inquiry Form is true.
  • My services will be performed for the public in return for compensation from the public.
  • The lease fee is a fixed fee and I will be responsible for the profits and losses of the cab I operate.
  • I desire to be an independent contractor and recognize that I will not be an employee of St. Louis County Cab Company, Inc., Yellow Cab of St. Louis, or the owner, or any other entity or person connected with my operation
    of a taxicab.
  • Prior to being eligible to lease a cab, I understand that a full background screening will be conducted including but not limited to; city and county criminal screens, motor vehicle record checks, drug and alcohol testing and physical. I also understand that periodic follow-up background screening will be conducted as necessary.

 
I CERTIFY THAT THIS INQUIRY FORM WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
(False statements, misrepresentations, or omissions may be cause for cancellation or denial of the rental agreement.)

Today’s Date:*  
Enter today’s date.Enter as mm-dd-yy.

      Applicant Signature: ___________________________
(To be physically signed at time of interview. Submission of this rental application form will be considered an electronic signature.)
Verification Code:  St. Louis Taxi, St. Louis Taxi Service, St. Louis Taxicab
Enter Verification Code:*  

Enter Verification Code above to proceed.
 
Please review ALL information entered BEFORE you submit this form. NO CHANGES can be made after submission. A copy of your completed rental application will be emailed to the address you provided above.