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Home My WebLink About14-120Authorization Number % 1 (Office Use Only) ��®-lit �'w .k , .,` C(ry OF IOWA CITY APPLICATION FOR TAXI/MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made 410 East Washington Street between 8 a.m. to 3 p.m., Monday— Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First dd >rM Lstti 1. Name �� 2. Mailing Address q ZdV �L . S. t 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: 5iu-y 6 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? wig 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? 1D' _ Tvpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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) � 6--1- 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) derk/taxidrivbadg 03/2014 I h�r by� Z� that �a�{e issued to me by the Iowa Department of Transportation a valid Chauffeur's license numbdr / . 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) j Signature of Applicant ��...� Date Sjh-) / 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 ) Subscribed and sworn to before me by & A:A k u f- -0V e S A ex-,- -)-f-. On this day of l,ka-,A , ")r-) q . WENDY S. MAYER imiseinn Number 729428 Notary Public ' and for the State of 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). g UM, -..1 -- -� -02 -Z-)� 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. Signage of City Clerk or designee' oZ Date / Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5'/Z" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update derkRaxidrivbadgeapp2014.doc 03/2014 05�May`21: 2014111:,1,7AMG�b Div of Criminal Investigation (FAX)31533827N0.0564 P. 13/13, STATE(JFZOWA ��,� Criminal History Record Check Request Form �'� DCI Account Number., 9967-F (IropplfcAblo) Tot Town Division or Criminal Investigation Fromt Yellow Cab of Iowa _City Support Operations Bureau, V Floor P.O. Box 428 2-15 L. 7'b Stroot Des Molnes, Tows 90319 Iowa City, IA. 52244 (B1S) 725-6066 _ (515) 725.6080 Fox (319) 338.9777 Phone: Fax, (319) 339-7302 I erre rnnunarina• an tnwn• Crirninni Y4t'Qtnry RnenrA rhPnir nn - Last Name mandatory) First Name (rnandatoryy, Middle Name crceomm4ded) -b(Z e,,Sb 6 (tP SfZ, �p, �NCtUC01u . Date of Birth (mandatory) Gander mandato 'Social-Securi Number recommended) VMale Mermale Waiver Information: Without a signed waiver from the subject of the request,a complete Criminal history record gray not bo releasable, per Code of Xowar Chapter 692.2, For complete criminal history -record In(prmatlon, as allowed by law, always obtain a waiver signature from the subject of the ra uett, Waiver Release, I hereby giro perrnlsslon: Or the above requesting efllolal to eonduct an Iowa criminal history record chock wlllt the Dlvlslon ofCriminal 1riY.4Piif�tli4A �Il.AI)Y�diN1[►B111aIM7Sla1LoALwID��1A�t1I;_Ma} Y//moi Waiver Slknalure: rl� Iowa Criminal History Record Check RtlrM.ts (DCI usoonly) As of C. , a search of the provided nsmo and date of birth revealed: r No Iowa Criminal History Record found with DCI ON CD Iowa Criminal History keoord attaohed,-DCI 9 G'. _ DCI initials DCI -77 (0812$110) " Received Time May, 15. 2014 4:25PM No. 8775 Iowa Department f 'Tr pi rt n Mice tit Dft w aennces (felt Free) t-532-1121 PO Box 92134, Des Moines, to 50306 OZ34 515-244-9124 F, - 515-239-107 Certified Abstract of Driving Record Inquiry Date: 5/23/2014 DL/ID #: Name: Dresden, Arthur Class: 7593269 Anthony Jr VAL Address: 4219 Lloyd Avenue Audit #: 12/11/2018 Se None 2L CDL Med Status: Issue Date: City/State: Iowa City, IA 52240 Expiration Date: Supplement: Endorsements: Mailing Address: 4219 Lloyd Avenue Restrictions: M Se Date of Birth: Mailing Iowa City, IA 52240 Sex: City/State: 960ZZ6211 (IA) Customer #: 1024572 D ID Status: None 7593269 DL Status: VAL 12/08/2013 CDL Status: None 12/11/2018 CDL Cert Status: None 2L CDL Med Status: None Corrective Lenses Restriction None Supplement: 12/11/1954 M History Information CLEAR DRIVING RECORD Name: Dresden, Arthur Anthony Jr DL/ID: 960ZZ6211 Pursuant to Iowa Code §321.10, I, 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: 10' D. 0. T elf Name: Dresden, Arthur Anthony Jr DL/ID: 960ZZ6211 5/23/2014 cll:: 7i Ca4gv� Office of Driver Services Iowa Department of Transporation