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Home My WebLink About15-014®® L CITY OF IOWA CITY I(0 6 A C r ty 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,Cily_ Iowa 52240-1826 fRILIYe f¢8 a, ,rr➢ ,leC&* '�H "E' �,(BiB' G.'�"q„il7foP781e�t'forG will Ye uAC fd7 l/L^rP9�9 ��XFP4? �.y AI?.atidan .319), 3 S 6-5040_�.s ( Q(319) 356-5497 FAX First M�id>dl / L st 1. Name (REQUIRED) /nof 2. Mailing Address (REQUIRED) _ O �� Authorization Number (OfficesU a Only) 3. Contact Information (REQUIRED) Email: A-, 4. Prior experience in transportation of passengers: M 'Cell Phone: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or Type of offense 6. Have you n convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? * is When When ,).. 9 - 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? Type of offense Where When DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CEIRTIFo. DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an Individual Department of Criminal investigation Report (form available upoh'tequest):d (OVER FOR REQUIRED SIGNATURE AND NOTARY) 09/2014 I hereby certify tha it have issue to me by the Iowa Department of Transportation a valid Chauffeur's license number W'�1% 7 96? / t�C I understand that if I falsely answer any questions in this application, that this application may bedenied. 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 " � U Date 1 � 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 ) and swom to before me by yak\ c -°n q R a - On this � (...0 t -_k day of the State 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). ►, , Sign ture f P ice W or designee 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'/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record , Website update Cierk7A)UDRNBADGEAPPL92014mm ded.DDC 09/2014 I Q I la,wIa4ms Mltuataa�al I re�(p.IIII � x VI � Iowa ��w �"allll8� I IIa=aa11 Mk -532. lu 4, IW 4's hfi dt eS, LA. 1150306 9AMt a Vit 2.440124 N AX-,5M,23,11-rW? ertifled Abstract of Ill rlitm Record Inquiry Date: 1/8/2015 DL/ID #: 934ZZ0218(IA) Customer #: 5153141 Name: Hunafa, Aloe Bilal Class: A ID Statm a None Address: 390 PADDOCK OR Audit 8603036 DL Status: VAL Issue Dateu 11/07/2014 CDL Status: VAL City/State: IOWAITY IA Lxplration 10/24/2017 CDL Cert Status. None rxct pted Endorsements: NONE CDL Ned Status. Not Certified Mailing Add 390 PADDOCK OR Restrictions: Corrective Lenses Restriction None Supplement: Date of Birth: 10/24/1982 Mailing IOWA CITY, IA Sex. M City/State: 522407235 CIDII. Medical IExemihDer",s Ceirtifficate aJarl�4ua��ptlx mwpa,a'IYllfim�r Lx11,olCawmlu wMloealormn .... IMedical IIxannilineii IIHii st Maine Claudiar R I I IMed1ca 111IIExanrlllrua, r Lad:: Ilwl+ nne autu-wilrl IlelnuVSt�aaW� Ixemnlluamw'° II.1¢a^iro",•arty IIW!auolmtra:u° 2726 I llvirdilcall II xminh mu 1Madaui M lkx.vylYMii4 gNlluuomvllno. ........ 9775. �uuD( P4(u3 N N ....... ........NN ....._ IMedurartll II x,allnmunfu tlaua lisdild llrulro IA uMarll alllExaurenl1wirllrton om (119).756 33.35 IIMedllra8 ExaklnNllunmr IYgt * I'''uhpil Iklin Assilstarit Miall -du llC lltlalrahe M,¢ tdr.boin I Wearing a;adll ire five IM':Inses IIMcdicu0 C'ni tuff tate IissRie d Daae. 0 .... .� .... . IlMeMcM P.a.u119TiicatelExjjallr,wUlloni Date M/2014 Date Added to &",IIMII.A IS IMiallling Wxxxll (��0412014 &�gnini I111wPOW t'wmInWcdiii�:am oattm ACID IV'� x�Illoirmurtlon Count tr ',;'luilIIW! m mm�nt.. ..., Gnjn!q/n p,:�;!', iV1/311i+.2012 r,92 Seined i, A0I!viiph & Kowa V'1u 'ausu�: eN in i1°m..�55 mph :aanne Meme; Hunafa, Mae Mal D L/':N'11D- 9347'ZO218 Pursuant to Iowa Code §321.10, I, Klm 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 so 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: 11%1 1!3/2015 EI, uw TC "ap mi ��v Office of Driver Services Iowa Department of Transporatlon i 9.2015.10:8AM Div of Criminal Investigation 00 0. LU17 z?�A �Iiy I,i;rx t,ilp of Iowa WLY STATE OF IOWA CrImIuR History RI';(u ul Check to I'terii;> 1 t iia TAWO MVISIOA OtUMITIal bIV6111911110h Iresmollmllowa 90319 (515) 726-6066 d i. Ao No. 7670 P. 1/1 No. D)z) r. z ---------------------- 9I(OMA —9LoLLQ 1qk Gty cboryew Ofiii ce 4W7, yovreo G a FA.52240------------- .3.19-356-5tGdX gIVer of air a i®n, Wifhovtt as dg nod waaver Warn tho NNbJeck odthe request, a cwVa phle oktmR null history rccord may not loo releasable, per Code ok`:b wa, Chap d9.23, IhNetofy record Iunt'or mathaxa„ as alfa as bya paw, aQwtaya ober'Rejed,99";; Cra wird an Iowa WOW hNLORIYa000ud ®bsaYe ewddu Ike MWAOR ofW afgaG ynya ¢1taIGoGw(Dco' Anyc�dxP OMRYIMWOKdataCOMMnovxgaatd,aaGsRnae,Y.abaad0a t��fx¢ngyA6atYodBo�'asellowodbyYaw $ LO re bu Ra . nsto.ru .._ (DCIvi6ody) As of------�:` — a search ofthe ,govdded name, and data e;tb th wvreaiedR r�> 14o Iowa CrfirdriaN..History Reeord.: oursd with DIC turas C ° " al ffieorr Rzoamd atitaefued.a DO NIs Recoiiwea T;me—Jd n. 8;x2015— 2:49PK—No.7615_____