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Home My WebLink About15-013Q � t CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX Authorization Number _ _ 1 ) (Office Use Only) Ir APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m, to 3 p.m., Monday — Friday.) Fa%laer p to o__ f/�te tiPE "e SaiP�Cl'" Pnf®�rlaaf%wfP 1. Name (REQUIRED) �j 2. Mailing Address (REQUIRED) 3. Contact Information (REQUIRED) 4. Prior experience in transportation of passengers: will nEst t in donial ofM ap%aAlcateon Cell Phone: °R i Q� g q ^ n 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsemtw 1 � 3�. Type of offense Where as w 1 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in tllt� last five years?' Tvpe of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Tvoe of offense Where When `.1, 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? Tvpe of offense Where When 9. Have p1 ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) 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 hereby cerpb t I have issued to me by the fowa Department of Transportation a valid Chauffeur's license number �, –7 A4_ I understand that if I falsely answer any questions in this application, that this ap tion may be denied. I 6nderstanifthat 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 ba signed in front of a Notary Public) Signature of Applin date M° YOU ARE NOT VAID40 DRIVE A`T0I 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 ) to before by e v a a _"' d"` t" IA ¢ a On this 1 v. "Aday 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). Srat Police Chief or designee DOT 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 �,C �y CIe ror desdgnee —� ate Taxi cab busuiesseiare rggpired to provide Driver Identification cards. Cards must be 81/2" (width) and 51/211 (height) and promirt'thtiy displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update ClerkR/WDRNBADGEAPPL92014amended.DOC 09/2014 Io Department a Tr iiu� III �r iouin ,,,�" P C.)140)( 9204. S hPlOan(m, ' t % 50306 9204 Sl % 244 ^m24 I-IV 515 239 I&V Certified Abstract of Driving Record Inquiry Date: 12/28/2014 Name: Arthur, James Joseph Address: 527 MEADOW ST City/ IOWA CITY, IA 5224550:1.9 Mailing Address. 527 MEADOW ST Mailing IOWA CITY, IA Clty/State: 522455019 DL/ID #c 043SS5374 (IA) Customer #: 1639571 Class: D ID Status, None Audit #: 6476952 OL Status: VAL Issue Date: 11/16/2012 CDL Status: None Expiration Dole. 9.9./7.'7120:1.'7 CIDIL Coon Status., None lhrwdorsementm 3 CIDL 1Red Status.- " Nona " Restrictions: Corrective Lenses Restriction - "None Supplement: Date of Birth: 11/17/1950 „ Sex. M History Information Namen Arthur, James Joseph DL/ID: 043SS5374 Pursuant to Iowa Code §321.10, 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: IOWA p IIS, 0. T. b ihN 8811% Office of Driver Services Iowa Department of Transpomtlon Name. Arthur, James .Joseph DL/ID: 043SS5374 State oflown Fill in all shaded areas. .x s . - an Iowa cirimi nal hktory reco. rd. c1heck on: ��at> ........................................................ . ... ... ............................................ -.1.1 .......................................... ........... ............................................................................. Last N ame Apeffick (wqaadstocy� 114rvt Name P'Pzmcp Nom&e (inwi&�my) Middle NznwsegundoNv,"C,ry (,a ....... ............ ....................................... . . . I ..................................................... ................................................................. ...... ....................................... ............ I ............. .................................................... Date, fpfffiv.,th, Pec -ha Vacamento (Aagn,datwy-) ( I � e., -n d --- e --- r ---- -0- -n- -fl- 4 b - -�-�"Y-) --------- S"odal Securf�y �N�q!.p!�er ow ............................................................. ..... .. .................................................... ...... -------------------------------- --- ...... --------------- IG (f Male Ole Feim ............................................. ---------------- —1-11 --------------------------------- - -- - --------- . ... . ... er Si Pu atu re S'vwa (if, Ih 0 Mq vAhn Im youn"d 1" Pdm RE a nip ff!ithe ro4u w, us on s w nevur, dsm, w ite N/ A ) Da USE ONLY A s of a inane end date of birth check revealed: -0. 1 No Tecord fmnid C%Hgcovd attached DCI# ............................. ......... DO fififiak Illecelpt W, ,Z Number of requests x $15.00 per last name = Total amount $ .... L ..................... Metbod of paymennnta cash rnoney order check # MasterCard or Visa Cardholder's name J.)CI initialk IA -P IDU 83 (09/09/ I10; Revise,d II O/ 1/1 Oibrurii reviewed. 08/11/14) 01 ARRESTED 19951014 AGENCY: IA0520200 IOWA CITY ED CHARGE NO- 01 IA STATUTE IAI24-401 POSSESSION SCHEDULE I TRK#: 007761701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 POSSESSION SCHEDULE I / MARIJUANA TRK#: 007761701 SENTENCE DI:SP EFF DA'' DEFERRED JUDGEMENT 3.9960208 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA 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 '][WAVK' THE RECORD COVERS THE SUBJECT OF YOUR IVQIYFRY. DIVISION OF CRIMINAL INVESTIGATrON IOWA CRIMINAL HISTORY DCT 00192705 COURT DISPOSITION PENDING FACE I OF I STATUS UNKNOWN pRTE PRINTED - 2014/12/26 DCI ;;00192'70: 5 NAME: ART HUR,JAMES JOSEPH DOE SEX RAC HGT WGT EYE HAIR SEE PON 19501117 M W 511 190 HAZ BRO MED DC ADDITIONAL IDYAWTIFIF!.lRS CCH RECORD 01 ARRESTED 19951014 AGENCY: IA0520200 IOWA CITY ED CHARGE NO- 01 IA STATUTE IAI24-401 POSSESSION SCHEDULE I TRK#: 007761701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 POSSESSION SCHEDULE I / MARIJUANA TRK#: 007761701 SENTENCE DI:SP EFF DA'' DEFERRED JUDGEMENT 3.9960208 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA 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 '][WAVK' THE RECORD COVERS THE SUBJECT OF YOUR IVQIYFRY. DIVISION OF CRIMINAL INVESTIGATrON