Complaints about a driver or vehicle. Please provide as much information as possible to help our Licensing Compliance team investigate your complaint. Witness Statement Please note, if you are not willing to provide a witness statement we may be unable to process your complaint fully. Firstly, would you be willing to provide a witness statement? Yes No 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. 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 Last Address Customer address Address Address 2 City/Town Post Code Contact Telephone number Email address Details of the Incident Date of Incident Approximate time of Incident Journey from End destination Details of Incident Vehicle and driver details if known Driver Name Driver Badge Number Vehicle Registration Company signage displayed on vehicle Has the incident been reported to the police? Yes No If yes please provide the crime ref number Which police authority was the crime submitted to? Name of Police officer What code is in the image? Enter the characters shown in the image. 13259
