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HomeMy WebLinkAbout15-033� r lot CITY OF IOWA CITY 410 East Washington Street Iowa City, lava 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX Authorization Number ) '� - 33 (Office Use Only) APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) Failure to complete the "required" information will result in denial of the application First 1. Name (REQUIRED) 1_ c Ij A e Middle Last 2. Mailing Address (REQUIRED) a `{ k' 5 pt."' n1 M'Zg O(cw Qv-, T.q 6"Iy 'rak q fdQ y0 3. Contact Information (REQUIRED) Email: Xlo13 ra a k 1 0 (9 7, , ror^ Cell Phone: 31 q 6;1- y/ 19 9 4. Prior experience in transportation of passengers: A a h v 1� Ori vi' w w i+6 YL (I ow 6G6 c } xo. ci fy 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 0 O Type of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? n) D Tvpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? y� S Type of offense Where When rollawi nG {00 C IoSQ Jy/ nCan C"�nty Wo _1k)0 Zn5Uu'nn c¢ t:n/r% jUtinSo Cevv Fy /2/p9//i 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? nJ 0 Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) ND DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an individual Department of Criminal Investigation Report (form available upon request). (OVER FOR REQUIRED SIGNATURE AND NOTARY) 09/2014 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number 7 6q i Y, 9 2 G / . I understand that if I falsely answer any questions in this application, that this application may be denied. I understand that if I falsely answer any of the questions in this application, that this application will be denied. I agree that in making this application, I consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to this application, and I further agree that, if a license is granted, to comply at all times with all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant,vw Date 19 / YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) I Su serib d and sworn to before me by LO nn Lo '`1 e-' On this �day of I 1.1F K. TUTTLE inner zz1a19 Notary Public in and for the State of Iowa i 4°IP�'s�SIDn _1i I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). Signa tuq of oti507 ef or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5 %" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update ClaMrMIDRNBADGE PL92014wended.DOC 09/2014 Iowa Department of Transportation A- office of E)WW Services (Tall Free) 800-532.1121 PO box 0204, DOS MolneS, 1A 50306-0241 515-244-9124 4=AVG b15-239.1837 History Information. Convictions Citation Date Certified Abstract of Driving Record ACD Inquiry Date: 2/13/2015 DL/ID #: 76908261 (IA) Customer #: 331290 Name: Loney, Lorne Linn Class: D ID Status: None Address: 2432 WHISPERING Audit #: 7743048 DL Status: VAL MEADOW DR Issue Date: 01/29/2014 CDL Status: None City/State: IOWA CIN, IA Expiration Date: 07/30/2019 CDL Cert Status: None 522406805 Endorsements: 3 CDL Med Status: None Mailing Address: 2432 WHISPERING Restrictions: Corrective Lenses Restriction None MEADOW DR Supplement: Date of Birth: 7/30/1967 Mailing IOWA CITY, IA Sex: M City/State: 522406805 History Information. Convictions Citation Date Conviction Date ACD Ex lanation County IUR 12/0912014 01/19/2015 11364 No Insurance Card Johnson IA 112/09/2014 01/19/2015 IM34 Following Too Close Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number ]UR 12/09/2014 832671 IA Name: Loney, Lonne Linn DL/ID: 769YY8261 Pursuant to Iowa Code 4321.10, 1, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a true and accurate copy of an official record currently in the custody of said Office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: '%JOICIi N 2/13/2015 .... -.iii, IOWA' r D. 0. T. PV1-51142 - - Illit" 9Ei� �1gSNu<a-. Office of Driver Services Iowa Department of Transporation Name: Loney, Lonne Linn DL/ID: 769YY8261 02/Feb_10_ 20154..3.44PM �,y Div of Criminal Investigation No. 0011 P. 1/3 -- (FAX)3163382,., r..../002 \ rrw'o: Criminal History Record Chet 'STATE OF IOWA Request e 0 Tot Iowa DmPion ofCrlminal Invostlgation Support operations 9uroau, 1tr Floor 21573, Th Stroet Des Moines, IDwa $0319 (515) 725.6066 (615)'725.6080 Fax DCI Account Number; 9967�F (lf oppilceble) Froml A""'1b ellowCab orrowa Citv )?,O, Box 429 Iowa City, IA.. 52244 (319) 338-9777 Phone; Pax; (319) 339-7302 �An 1~30~ 6-% I ski ale ClTtemate Waiver 1q/ermarlon. 'Without u signed wnlvar from The subject of the raquest, a complgte yrlminal history reoord miay not be releasable, per Code of Totva, Chapter 692.2. For co. mnlete arlminal history -record Information, as allowed by haw, always nhtalh ,t Wnlv.x •Inwet.,.. A...... It.....t.t.-. -w— - ..... _. Waiver Release; l hcrcbygive permhelhn [by ha above roquctling 0111111111 10 conduct en lows edminsl hislory record check Willi the Division Of Cominal Invostisulon (OCD. Any criminal hisrary due eoheahtingtns that Is malntsinod by the i may be relasted es eltowell by law, W171vdr SignatUret Iowa Criminal History Record CheckResults_ (DCI toponly) As of aI 0 { `5 , a searoh of tho provided name and date of birth revealed; © No Iowa Criminal history R000rd found with DCI /M' Iowa Criminal History Record attached, DCI # DC1 initlals DCI -77 (08/25/10) Received Time Feb. 9. 2015 6:48AM No,0466 Feb.10. 2015 3:44PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00452732 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTRD- 2015/02/10 DCI:00452732 NAME: LONEY,LONNE LINN . LONEY,LONNIE LINN DOB SEX RAC HGT WGT EYE HAIR Sm POB 19670730 M W 510 210 HAZ BLK MED IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19921229 AGENCY: IA0510000 JEFFERSON CO 90 CHARGE NO- 01 lA STATUTE IA716-4 CRIMINAL MISCHIEF 2ND DBGREE TRK#: L43189301 CHARGE NO- 02 IA STATUTE IA708-11 STALKING TRK#: L43169302 COURT DISPOSITION AGENCY: IA0510150r JEFFERSON CO DIST COURT COUNT NO- 01 IA STATUTE IA716-9 CRIMINAL MISCHIEF STA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L43189201 SENTENCE DISP EFF DAT JAIL SSD 19930318 COURT COSTS 3 1/2 CREDIT 19930316 SERVED/MITTIMUS FOR 11 1/2 DAYS PROBATION lY 19930318 SUSPENDED 15D 19930318 COURT DISPOSITION AGENCY: IA051015J JEFFERSON CO DIST COURT COUNT NO- 02 IA STATUTE IA708-11 STALKING CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L43189302 SENTENCE DISP EFF DAT FINE $50 19930422 15 RESTITUTION/25 DOLL COSTS 02 ARRESTED 19971115 AGENCY: IA0660000 CHARGE NO- 01 OWI IST TRK#: 013637401 COURT DISPOSITION AGENCY: TA0560151T COUNT NO- 01 LEE CO SO IA STATUTE IA321J-2 LEE CO DIST COURT IA STATUTE IA221J-2 No. 0011 P. 2/3 Feb. 10. 2015 3:44PM Div of Criminal Investigation NO. VVI I 1 • J, owl TRK#: 013637401 SENTEN09 PLEAD GUILTY DEFERRED JUDGEMENT COURT COSTS PROBATION DCI 00452732 PAGE 2 OF 2 DISP EFF DAT DDSISUB ABUSE EVAL AND TRMT 19980203 19980203 19980203 lY 19980203 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAXNRD.BY THE TOWA DIVISION OF 'CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRE'. DIVISION OF CRIMINAL INVESTIGATION