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Home My WebLink About15-0253. Contact Information (I.EQUIRED) Email: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ape of offense Who /,d A°°„1 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? bleu r 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 themame(s) 'A/0 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CSRTIFIEDlo DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIIEF°'REVIEW You must apply for an individual Department of Criminal Investigation Report form avalla4 ll ,. ons uestD �, (OVER FOR REQUIRED SIGNATURE AND NOTARY) (MSCI Authorization Number 1 1 (Office Use Only) CITY €3F IOWA CITY APPLICATION FOR TAXI ! MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 410 East Washington Street Iowa City. Iowa 52240-1826 �:� �� ¢)w�°!",Y��,�d��"'�&".:� &"q'"� ;d��tl d'W°Nt�A�P_.:u_k"' z;Y�AR�q_'d A&Lre,sdBl''l 9�Q_&i�¢:nialwaSlwt'�&R�wgj2p g�y'C_'PRq&IYd (319) 356-5040 (319) 35G-5497 FAX First Middle Last 1. Name (Rl:CkI iRED) 2. Mailing Address (RE6.',)t.d REl:) 3. Contact Information (I.EQUIRED) Email: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ape of offense Who /,d A°°„1 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? bleu r 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 themame(s) 'A/0 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CSRTIFIEDlo DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIIEF°'REVIEW You must apply for an individual Department of Criminal Investigation Report form avalla4 ll ,. ons uestD �, (OVER FOR REQUIRED SIGNATURE AND NOTARY) (MSCI 1 hereby certify that i have issued to ma by the lows Departmant of Transportation a valid Chauffeui's licence nunrba:r 5 q W/IT! understand Thai if I falsely ansvver any questions in this application, that tris application may be denied. I understand that if 1 falsely answer any of the questions in this application, that this application viill be denied. I agree that in making this application, I consent to al!aw 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 iicenae 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 E3 Date ,..- i ------- YOU ARE NOT VALID TO DRIVE A -','-AXI IN IOVVA CITY UNTIL AUTHORIZATION ES RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city wabsite at icgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn tp, before me by, �A •k i,A J1. �!Irm rv�.r..—• On this day of i have reviewed this application, DCI rapore, and the State certified driving record of this applicant and have detsr-- mined that there is no information which-4iculd indicate that the Issuance would ice detrimental to the safety, health or welfare of residents of the City of Iowa Clty (Title 5, Chapter 2, City Code). Signature 7TVALID ief or designee D to YOU ARE 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. �.... D e Signature of City Clerk or designee Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/2" (width) and 5'/z" (height) and prominently displayed to ail passengers. Office Use Only Approved application DCI report State certified driving record Website update ClerkrrA)aDRNBADGEAPPL92014e nded.DDC 09/2014 X �Po il, A", 0 � 0 T wwwJowadotgov f, mice of DfivefS"Mc6s PO If:W W04 a Des Ii a, ih 50;1/Pru-9:2F.W Theme„ 545IW9124 k SI II. Fw. 5.15-.2. 9-18,37 W.+.�nlruc9uta:,pme Inquiry Date: 1/28/2015 DL/ID #: 596AH4569(IA) Customer : 5955498 Name: Algaali, Bahaeldin Class: D ID Status: None Akasha Addresm 2525 BARTELT RD AFT Audit #i 6994884 DL Status: VAL 1A Issue Date: 05/31/2013 CDL Statues None City/State: IOWA CITY, IA Expiration 10/23/2017 CDL Cert None 522462718 Date: Status: Endorsements: 3 CDL Med None status: Mailing Address: 2525 BARTELT RD APT Restrictions: NONE Restriction None 1A Date of Blrth: 10/23/1973 Supplement: Mailing City/State: IOWA CITY, IA Sox: M 522462718 History Information Date Case N u��llober JUN Name: Algaali, Bahaeldin Akasha DL/ID: 596AH4569 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: M 1 M 7114 =Jopsivy 1 • Office of Driver Services Iowa Department at Transportation M SPOWA fjs Request Form" r' Criminal History Recoxid Check i r °. To- Tom D19181011 of C&AN&A hWeallgation ROM., —Q�Y-�� DUMOMN, IOWA 50519 (015) 72&6966 �i Faw ---- Iowa CrimindjftLtory R__&qord Check Results As of a se000h of theprovIdedname asad date ofbixdtrovealeda , No Iowa Q-1minal Matory Record (bund with AC1 To a ObArial Histaxy Record attwhed, DQ17R Dcl rials Received Time; -,M 28;—„1015-11e53AW-No, 908 Jan.29. 2015. 1:121 Div of Criminal Investigation No.9176 P. 1/1 o Jra'n. Lo. LUIS I1M blly blerK — Lily OI roWa lily ko.77Y9 P. SPOWA fjs Request Form" r' Criminal History Recoxid Check i r °. To- Tom D19181011 of C&AN&A hWeallgation ROM., —Q�Y-�� DUMOMN, IOWA 50519 (015) 72&6966 �i Faw ---- Iowa CrimindjftLtory R__&qord Check Results As of a se000h of theprovIdedname asad date ofbixdtrovealeda , No Iowa Q-1minal Matory Record (bund with AC1 To a ObArial Histaxy Record attwhed, DQ17R Dcl rials Received Time; -,M 28;—„1015-11e53AW-No, 908