Taxi Pass Application

Legal Name
Enter your legal first and last name as it appears on your ID.
Do you have a preferred name different from your legal name?
If you use a name other than your legal name please check yes.
What name do you prefer to be called?
You must be 18 or older, unless you are attending Northern Lakes College.  Independent Minors age 16 or 17 may apply with a referral, please contact (780)624-1000.
Please enter a phone number so we can contact you about your application.
Street Address
Enter the STREET address where you live in Peace River. A box number is not valid proof of residence.
Attach a photo or document showing your name and street address.  
Example:
 Lease, utility bill, bank statement or government letter
One file only.
15 MB limit.
Allowed types: jpg, png, pdf, jpeg.
50 MB limit per form.
Do you have a mailing address different from your street address?
Do you hold a Taxi Driver permit in Peace River?
Taxi Drivers are not eligible for the Taxi Pass program. If you obtain a Taxi Driver permit while you are on the program you will no longer be eligible to purchase passes.
Are you a student at Northern Lakes College?
Please attach a document from Northern Lakes College confirming you are enrolled and showing your start and end dates.  
One file only.
15 MB limit.
Allowed types: jpeg, jpg, png, pdf.
50 MB limit per form.
Do you receive AISH (Assured Income for the Severely Handicapped)?
Please upload your AISH statement, ensuring your name, the date and the Budget Info sections are visible.  If you do not receive Health Benefits your name and the date will be at the top of the page.
One file only.
15 MB limit.
Allowed types: gif, jpg, png, svg, pdf.
50 MB limit per form.
Are you a Senior age 65 or older?
Please upload proof of age, such as ID or a birth certificate.
Maximum 3 files.
13 MB limit.
Allowed types: jpg, png, pdf, jpeg.
50 MB limit per form.
Maximum 3 files.
15 MB limit.
Allowed types: jpg, png, pdf, jpeg.
50 MB limit per form.
Are you married or do you live with a partner? Select No if you are divorced or separated.
Enter your spouse or partners income from Line 15000 of their most recent Notice of Assessment.
One file only.
15 MB limit.
Allowed types: gif, jpg, png, svg, .
50 MB limit per form.
Do you have dependent children under 18 who live with you?
Dependent child means that you are the parent or legal guardian of the child.

Please list your children who:

  • live with you
  • you are their parent or legal guardian.

To add more children click on the plus icon next to the row, or click on Add.

NameAgeBirthday

By submitting this form you are consenting to the collection and use of your personal information.

The personal information on this form is collected in accordance with the Section 33 (c) of the Freedom of Information and Privacy  Act and is collected for the sole use of the Town of Peace River for the administration of the Taxi Pass Program.   If there are any questions about the collection or use of this information, contact the FOIP Coordinator at 780-624-2574, 9911 100 Ave Peace River, AB. 

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