Regulation 4(a)
SCHEDULEFORM OF NOTICE OF EXEMPTION
[Name of Licensing authority]
[Full name of driver], the holder of private hire car driver’s licence No. [number of licence], is, during the period [insert dates of beginning and end of period of exemption], exempt from the duty to carry guide dogs, hearing dogs and assistance dogs–
(a)in the private hire car having registration mark [registration mark of private hire car] and licence number [licence number of private hire car]*;
(b)in private hire cars with fixed partition segregating the driver from the passenger compartment*;
(c)in private hire cars without fixed partition segregating the driver from the passenger compartment*.
* delete as appropriate