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Home My WebLink About15-0586. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? _hL9— UMMMOM What happened to the charge? (Circle one) Wher.e. W...h..@..n. Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last Eve years? fy.m. Qfoffe se. Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your drivers license or chauffeur's license been suspended or revoked in Lhe hast five)earb? IyD@ of olifense W? here, Vftn 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s), G,df rnt, DEPAFumilEN'r oI::: CRIMINAL 11INVES71GAT110N (DCI) IREPOlfslf ANi:),W-A6T..Er DRIVING RECORD imusir ACCOMPANY THIIS APPILICATION FOR POLICE CHlF.:i::: IREVIEW You must apply for an lndlividual Departaient of Criminal linvestllgaUon Repoft (Torun avWlablle upon request). (SIECOINID PAGE FOR IrtlE QUIlRED SIGNATURE AND NOTARY) c "2 DISNI IIF I'1101N No C", l Z =2�31 (Office 6se Only) -N`1 CH Y OF IOWA CITY APPLICA111ON FOR '117AXICAB / 11MOTOR1ZED PIED11CAB VEE11-411CLIT DRIWElik, (Pollice Departamrit reAew irriust The inade between 8 a,.M,E to 3 1W o'nday - Friday) 410 East Washington Street jk�"aJ,,o�,rm, on vvffl �n, f,,1 mfh,,,,0 , .1 , - - -a 11 .52240-11926 Qtk i D 3S6 5 04 0 34 , 9 7 FAX Middle LaM 1. Name (Rlll"'Quwu=iU:1) caal] ken, verf'/)- 2. Address (1:ZE(.,tUtR(E:D� U0 '1di ei v3. ContactInformation (REQUM""11=D) p Email:. C( ftjna�,W, �L Cell Phone: Vl� "I tV ... .. ..... -------- a (WIvWii�en communicatic nt via email) 4a Chauffeur's License expiration date (1:0: (11 I'll In: D);0;1 -�2 b. Taxicab BusinessName [ jI),) 5. Prior experience in transportation oll I jassengeim! diftav NIVIS A, 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? _hL9— UMMMOM What happened to the charge? (Circle one) Wher.e. W...h..@..n. Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last Eve years? fy.m. Qfoffe se. Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your drivers license or chauffeur's license been suspended or revoked in Lhe hast five)earb? IyD@ of olifense W? here, Vftn 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s), G,df rnt, DEPAFumilEN'r oI::: CRIMINAL 11INVES71GAT110N (DCI) IREPOlfslf ANi:),W-A6T..Er DRIVING RECORD imusir ACCOMPANY THIIS APPILICATION FOR POLICE CHlF.:i::: IREVIEW You must apply for an lndlividual Departaient of Criminal linvestllgaUon Repoft (Torun avWlablle upon request). (SIECOINID PAGE FOR IrtlE QUIlRED SIGNATURE AND NOTARY) AIII'"III'"III..IJA."ri'"IIOIIWIIl-ffll" "'III"Aril'CAII Vll'IIII:II lCLl'III:III':UIII'UIIVEII'H Page J times with all of the provisions of Titl 5, Cha t of the City Code. (Bleeds to be signed in front of a Notary public) q W, Signature of Applicant Irriariv:r„ ..... 'k#*k*&i-*&*trh****Wt*WWW%WWA'k&*lM**kk***#S***'Pr** STATE OF IOWA ) C®t1NTY OF JCFINS®N ) s 8� fp to .before me by ri.aYw a..... t N ... on this 1 ...m day of Subscribed and sworn �. U NASA an:� k;2s II1r�&d:.r I� i.arik0 orn kirndriou fire �.dt-0te u�0' Ionr<b @1E-0iA$cRdEd4'NkRNFNdERkkp.kd[IXtivk &'k'*dv*4Wd[h#.**1[kN'kk A&*kµµ'*h'AAP*k*AAO'Xhkkal&'aF'Ak&JEkk'IW'h'N'6:R'RLk'ih%AkAYVJ P::&'dv*WAWf:✓tA'Rkkk$e*kk'kkN*kIX**'4tl4*k4'kW*'*kRHAkA%A&h4d:dkA hiA**A... F, or welfaCity re of residentsi,City Chapter ' n+ sugnalu�re of d ClhNerior desugimee Date AM"EIR APPROVAL BY THE CITY CI"II'ER a YOUR AMC" AU 'l"HUORIZIw'II:D "IM DRIVE A"rA ICAlB IN Mf. WA CITY FOR INO MORE "ri IAN ONE YEAR FIROM "II"BNIE HIDA` E IL.11SIF D IW BLOW, TI -IE EIFIF'lw'C"r1@fl UDA'lr'E WIIII...U...1mA°II"CHI 'r1IE CHAUFFEUR'S II...I IF.II9SE IF pIIIRA710N IF U..II"SS "rH1AN A YEAR. iL l Siigna xro of Cii&y CIleuIr or desiignee 'A'R-k*kW*tr%*%*%'kA'*f5%k'#'k'kkTtiAArt'***ki'A**#kb:*kkA*%*tk**'kWk*kA****kkkk'k*k*ka5.4'deMi.-AY:**kF**'kA*^kkk'**k*k*feW*h'NW1tk&%'k'kkt[kkk****5h'h*'k'A*kkW*k*k%*****ARfrA'***P* Office Use Only Approved application DC1 report State certified driving record Website update cw,ra AMDRrVEM)GEAPM.92a141,%tWYaI�I.s.rwoc 02/2015 Mar10 2015.11,30AM Div of Criminal Investigation No. 2598 P. 2 NMI -'I.' evil au,vunu �a-y oac-R a.iay va -sea � ry Ru.907L P. I r� Cri 'TATE OF IOWA ''�Y.�� , Request I u Ta: Iowa bMeloa of Crlmlual 11twgigatlou Support Operations Bureaus 1N Floor 11511, 7° Stroot DesMain", lowa $0319 (515) 73M-6066 (515)7356000 Fax I aura roan Nun an. DCI A000w Number e ml from: alp 0110raa aft Aeries O&t' w 4'I0 ffi morwtnmtou Strook ;Iowa -C-1 IA 62440—A Phoney310 96.5041 ....m ........ ................................................................... Fax- 3"6-3497 c7w7& leg, G leap / N 6,sd r Data of BArth ON an ea aromrl Social securl �0r lyes® ea ...✓12 �� ale Ifmraopo✓1N .............................................................................. Waiver IfiforotaflaW wilbout a slgaed walvarfrom tho.sublmebofths irequued, o eoaupkmle e0vainal history rocor6 may not k aaleaaalnlc, per L'oda at Iowa, Chapter On.. Pal, Isle a tuaq Watery record Reformation, as all lay law, allwepo aive? Releam. Hanby 00nr pftlhul Wed twffghedwrre; p. tyro arhm6Rmn malwymord ahee#wi-n ahs Mamma orCrluaaauvl bm Mewed os wrad br Pm, ay, a mammaaaama &Ago yr aria Um as %4a Putrv.mw Aa of ........... 3..... a search Df the provided mmet mid date of 'birth revealed; No down Q'imirnal History Record found wrath DCI 13 rowa Criminal History Record attaolrcd, DCY. F_...._� .' DCII dt►IlWl ........... err cry invh c n o'k Received Time Mar. 4. °2015 10:04AM Ro 1621 PIowa Department of Transportation PO RMWIM, nes MCI 1A SOMWa"MI 54S'M'Mx FAX-61S.M1937 I itatxuAt. Certified Abstract of Driving Record tul Duiw Inquiry Date: 3/6/2015 DI ID #: 382AE5856(IA) Customer #: 5197916 Name: Clement Gonzales, Class: D ID Status: None LoWsa Raul Cesar - IA Address: 1101 PRAIRIE DU Audit : 8889598 DL Status: VAL ........... ........... CHIEN RD ............ ----- 2202) Issue Date: 03/04/2015 CDL Status; None City/Staten IOWA C N dA Expgration Date: 08/12/2022 CDL. Cert Status. None 08/2,..✓201,7. 522455929 10/07/2012 S92 Speed (1.0 Rnph 8 II o uIsa Endorsements: 3 CDL. Med Status. None Mailing Address- 1101 PRAIRIE DURestrictions- under in 35-5�unph NONE Restriction None ............... ............... CHIEN RD ............. ...,....... ......._.... Supplement: MQUMtle Date of Birtien 8/12/1986 ai4f73/r¢Dtl.3 _. _ Maligngg IOWA CITY IA Sona M T2s .. Clty/State: 522455929 04/23/2013 1lrn1vranper ILoauilra'Idd History rnfor atiorn I itatxuAt. tul Duiw A�4D ............................. --.1 o toumtm....... _.... u.l/:0.gk/20.G,0 p.l/I.dS/2010 S92 Speed (.9.0 unialh a. LoWsa - IA I under In .DIY- 55 nnph ........... ........... ............ ----- 2202) aD"r,{3a0/�d;,f1,OrA ............... Ofl?/O I��SD71.2 .... ._ SI!"w„---.______�.--.. ... Spkeed .... ..... ........... Ifi. ......... 08/2,..✓201,7. 10/07/2012 S92 Speed (1.0 Rnph 8 II o uIsa ............. Ih,. under in 35-5�unph ............... ............... ............. ...,....... ......._.... MQUMtle ......... roI/g /agpl ... ai4f73/r¢Dtl.3 _. _ 864 ..... ......... Moll wuaurrn Caud — -- IlouuIi az T2s .. O3/16/20: 04/23/2013 1lrn1vranper ILoauilra'Idd Pursuant to Iowa Code §321.10, 1, Kim SnooK, Director of Office of hereby certify that I am the custodian of the an official record currently In the custody, of said Office, and that I hpI 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: Name* Clement o» on Wes„ Rme l Cewam IM/M MAr 382AESSSS