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Home My WebLink About15-004Authorization Number_ _ 1 1 (Office Use Only) C CITY OF 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. lorea 52240-1826 Ea lufa.,P„eu,) ca(zf tg„@��..."..`.f . ul7e,information idif result in denial off�a�! a�2)roA®�;�A,eoav (319) 356-SO40 ° _ °°° (319) 356-5497 FAX First Middle Last 1. Name (REQUIRED) t �_�tP C15 C t y ��i tcti m 2. Mailing Address (REQUIRED)° 3. Contact Information (REQUIRED) Email: cell Phone: -7 l m9 4. Prior experience in transportation of passengers: c 1 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere?r� e of offense ra u I 6. Have you een convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? C� I IV= 7. Have you been convicted of any traffic offenses in the last five years? 611 � D29 of offense Where U 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 names) ,,, DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIF16" ti DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an Individual Department of Criminal Investigation Report (form available upon quest).` (OVER FOR REQUIRED SIGNATURE AND NOTARY) 092014 I h�y ty that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number " 3rd 8 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. (Peals to be signed in frcn" of a Notary Public) 1 Signature of Applicant ` Date l� YOU ARE NOT VALID TO DRIVE A TAX] IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) S d bscnbeand sworn to .�; � � w• "�,c� is before me by " wcap 1`�e ry�r ` On this day of a of Iowa 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). Signat oli e..thiefordesignee .—E26-1-5 Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS 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 W (width) and 5'/z' (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update 0M()f4 CierkrrA%IDRNBA..DGEAPPL92014=ende&DOC 11wI` 'a � elll iii ivi "Tra gasp i � ��,�u 5W,m2JVt TN �-d",X 515,234 183F Certified Abstract of Driving Record Inquiry Date: 12/23/2014 DL/ID : 091FF3450 (Dl) Customer #z 4069858 Name: Williams, Michael Class: D ID Status. EXP Joseph ulndely in,35-55 mplh Address: 2225 10TH ST Audit #: 8675406 DL Status: VAL 03/20/201:5 05,10512013 Issue Dolan 12/09/2014 CDL Status: None City/state: CORALVILLE, IA Expiration Datin 12/18/2019 CDL Cert Statmn None .522411327 ZW _. .. R14 113 2013 �. /..:........:......._ L.. &1a 1,.ro/201,3 Endorsements: 3 CDL Med States: None Mailing Address. 2225 10TH STRestrictions: 11564 NONE Restriction None 02/'116/20114 061241201,4 592 Speed (1.0 Inulplh 8. Supplement: 1A Date of Birth: 12/18/1965 I Mailing CORALVILLE, 1A . M City/State: 522411327 MIA Faii1110 Obey Traffic Johnson 1A History Information s"vil m ^,:ill mall .h0tation—.. �M`. 4^anllnpvll ielm 111U4'sta� ACID 111x 91a119a1iell'A '. e0.1111'ht� ... .I It 05/05/20110 06/21/201.0 592 Speed (1.0 Im4pnlh it Johnson 1A ulndely in,35-55 mplh ............ ....... .._..... . zone) 03/20/201:5 05,10512013 S92 Speed (10 mmplh & Johnson 1A under in 35...55 um:plY: ZW _. .. R14 113 2013 �. /..:........:......._ L.. &1a 1,.ro/201,3 592' ................................................A.^......'.1..:... S eoal ..... Vanluun�¢rcslm 1A 07011212.p�.1.�................._,_.. 02/0�r - 1..'�............................... 11564 No lins'u irainc ^ Card :J Johnson ......................................_.................................._..................................................... 1A 02/'116/20114 061241201,4 592 Speed (1.0 Inulplh 8. :iohnsolm 1A under in 35-'S.5 mmplhl I ........ ...... _._..____..._. ......................................................................... T01ma;,^.'k... 09/.12/2014 R0/23/2QD 10A MIA Faii1110 Obey Traffic Johnson 1A s"vil m ^,:ill mall fault or givenio f Name: Williams, Michael Joseph DL/ID: 091FF3450 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: "N°E 12/23/2014 III NN IOWA. i �14� �� 7 office of Driver Services Iowa Department of Transporation Name: Williams, Michael Joseph DL/ID: 091FF3450 12A!c-24e 2014oj 35PMCab Div of Criminal Invest gat on i STATE OF IOWA C Ie Clininal Historyr ea Request I Tog Iowa e n sapportopurntiom Bureau, 215 X 71k silver Des 03 (515) 725-066 (315) 725-6080 Fox i i DCI Account Number: __,9967-F. i Ar®pa:r�are) FromFroms Yellow y of o, Box 428 Phoni X11 (319) 339-7302 ' % �� ,,: ,,, « , As of a acin4h ofthe provided a and dateof birth revealed - 1 13 N6 Iowa Criminal Huntory Record found with DO Iowa Criminal4ry atoI o attached® DCI n� Received Time Dec.23, 2014 10:07AM No, 1619 (DCI L" only) i Dec.24. 2014 12:35PM Div of Criminal Investigation No.6911 IOWA CRIMINAL HISTORY DCI 00366630 MISDEMEANOR CONTZCTIOPS ONLY PAGE 1 OF 3 DATE PRINTED— DCX :00366634 2014/12/24 N E: WILLIAMS, MICHAEL JOSEPH DOE SEX RAC HOT WGT EYE HAIR SKM POS 19651218 M B 602 170 BRO BLK BLK IL CCN RECORD W'+• r s� AGENCYs 1A0S20200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA321-210-A CHARGE NO— 01 IA STATUTE IA700-2 ABSKULT CHARON NO— 02 IA STATUTE z 21210 TRK#s L32981901 DRIVING ER SUSPEND COURT DISPOSITION COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT No— 01 IA STATUTE IA700-2 DRIVE UNDER SUSPEND ASSAULT CHANGE CLABSt MISDEMEANOR CONVICTXON ,. CHARON S: MISDEMEANOR CONVICTION TRK#: L32981901 DISP EFF DAT PLEAD GUILTY 06NTENCE FINE $25 DISP EFF DAT PLEAD GUILTY 19890515 19870920 FINE $75 19870920 COURT COSTS $20 19870920 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA321-210-A DRIVINQ UNDER SUSPEND TRK#: L32982001 CHARON NO— 02 IA STATUTE z 21210 DRIVING ER SUSPEND TRK#: L32982DD2 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA321-210—A DRIVE UNDER SUSPEND CHANGE CLABSt MISDEMEANOR CONVICTXON ,. TRK#: L32902001 SENTENCE DISP EFF DAT PLEAD GUILTY 19590515 FINE $25 19090515 COUNT COSTS $10 19890515 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COUNT COUNT — 02 IA STATUTE IA321-210 DRIVE UNDER SUSPEND GE CLASSi MISDEMEANOR CONVICTION P. 2/4 n Dec.24. 2014 12:35PM D v of Criminal Investigation TRK(): L32982002 TL4TENCE COSTSPLEAD GUILTY MINE $25 ZOURT 03 ARRESTED 19900113 AGENCY: IA0520200 IOWA CITY PD CHARGE - 01 IA STATUTE 236-12 ASSAULT CRUSING INJU ESTIC ABUSE TRK#: L32982101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT - 01 IA STATUTE XA723-4 DISORDERLY CONDUCT CHARGE CLAM MISDEMEANOR CONVICTION TRK#: L32902101 SENTENCE JAIL 5H FINE $20 CREDIT W/TINS SERVED 5H 04 ARRESTED 19941211 AGENCY! IA0320000 JOHNSON CO 90 CHARGE NO- 01 IA STATUTE IA321J-2 owl TRK#: 012456201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT Co . 01 IA STATUTE IA321J.2 OPER VAN WE INT Owl CHARGE SS: MISDEMEANOR CONVICTION TRK#! 0124SG201 SENTENCE JAIL dell FIN$ $600 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 Owl TRK#: 027165301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(H) ODAR VEN WE I (OWI) / 2ND OFFENSE DISP EPP DAT 19990515 19890525 19090515 DISP EBF DAT 19900427 19900427 19900427 No.6911 P. 3/4 Dec.24. 2014 12:35PM Div of Cr,m nal ]nvestgat;on CHARGE CLASS: MISDEMEANOR CONVICTION TRKµ: 027165301 SENTENCE DISP EFF DAT SUSPENDED JAIL 53D 19970207 JAIL 60D 19970207 FINE $750 19970207 PROBATION 19970207 AGENCYs LA0520200 IOWA CITY PD CHARGE .. 01. TA STATUTE IA321J-2 T 3RD OFFENSE TRK: 100376201 COURT DISPOSITION ENCYi IA052015J JOHNSON CO DIST COURT COUNT — 01 XA STATUTE ZA321J.2(B) OPER VIE WN INT (OWI) / 2ND OFFENSE COURT CASE ID: 06521 ONCRO60267 CHARGE CLASS! MISDEMEANOR CONVICTION TRK#: 100376201 SENTENCE DISP EFF DAT JAIL 14D 20021021 FINE $1500 20021021 No.6911 P. 4/4 AM ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD INTAINED BY TIME 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 BED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RRCORD -- COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION