[Full name of driver], the holder of taxi 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 taxi having registration mark [registration mark of taxi] and licence number [licence number of taxi]*;
(b)in taxis with fixed partition segregating the driver from the passenger compartment*;
(c)in taxis without fixed partition segregating the driver from the passenger compartment*.
* delete as appropriate