Complaints about a driver or vehicle. Please provide as much information as possible to help our Licensing Compliance team investigate your complaint. Witness Statement The purpose of the witness statement is to provide written evidence to support a complaint that will, if necessary, be used as evidence in court. Once a statement is provided you may be asked to give evidence in court. Please note, if you are not willing to provide a witness statement we may be unable to process your complaint fully. Would you be willing to provide a witness statement? Yes No City of Wolverhampton Council Private Hire & Hackney Carriage Complaint Procedure Please provide your details so we can keep you informed on the outcome of the complaint you wish to raise. Name Customer name Title Title - Select -MissMsMrMrsDrOther… Enter other… First name Last name Address Customer address First line of address Second line of address City/Town Postcode Contact Email Phone number Details of the Incident Were you a passenger? Yes No Date of Incident Approximate time of Incident Journey from End destination Details of Incident Evidence Upload any images or documents? Vehicle and driver details if known Vehicle details Vehicle Registration Company signage displayed on vehicle Driver details Driver Name Driver Badge Number Police report Has the incident been reported to the police? Yes No Reported to police Crime ref number Name of Police officer Police authority 13259
