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Home My WebLink About15-0031 CITY OF IOWA CITY 410 East Washington Street Iowa Cit Iowa 52240-1826 (31 356-5O�q 1 (3 19) 3S6-5497 FAX 1. 2. 3. 4. Authorization Number,., Q (,� l (Office Use Only) APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) Faldcrra Ccs corw 2191st„4M'I'mol_'rq—f"',eea%wrdsaafiora uvddAre,sudf ire Iden®al of thq ars ddcating First Name (REQUIRED) 7, &k— Mailing Add k_MailingAdd (REQUIRED) Contact Information (REQUIRED) Email LLL Prior,,pxperience in transportation of passengers: 5. Have you ever been cc �e o 0 ffense 5 13, 6. 6. Have you been aSnvictl years? Type of Offense Middle Last Phone 8 n ... of any misdemeanors and/or felonies in this State or elsewhere? M" IY,e�r��1��.7 A9 A, a p jj�11 K.. a motor vehicle while under the influence of alcohol or drugs in the last five 7., Have you been convicted of any traffic offenses in the last five years? 1 Where When A 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Ii''l 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 th0ir)ame(s) s DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE= CERTIF/IED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an individual Department of Criminal Investigation Report form available u rin reQrue6t . (OVER FOR REQUIRED SIGNATURE AND NOTARY) 09/2014 )r ert hat i ave issued to me by the Iowa Department of Transportation a valid Chauffeur's license num!--" ere c � , r ,,,.... I understand that if I falsely answer any questions in this application, that this application bede��i denied. y Hied. 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) ��✓9v tSi9nature oApp cant"Da � r' 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 legov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) yy "'" scribed and sworn to before ma by C rdJiC )! . l" -LM d' m ) On this -sd """" day of Notary Public in and for the State of Iowa 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_msidepts of the City of Iowa City (Title 5, Chapter 2, City Code). or Dat 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. Signaturb of City Clerk or designee Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/2" (width) and 51/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update CIe,WrAXIDRNBADGEAPPL92014emwded.DOC 0912014 '00 ago i U DOT off -ice or Driver Services Inquiry Date: 12/30/2014 DL/ID #: 769YY2955 (IA) Customer #: 2349835 Name: Hamrick, Chadwick Class: D ID Status: None Aaron Address., 2518 INDIGO DR Audit M 7661903 DL Status: VAL Issue Date„ 01/02/2014 CDL Status: None City/State: IOWA CITY, IA Expiration 04/11/2022 CDL Cert None 522406808 Date: Status: Endorsements: 3 CDL Ned None Status: Mailing Address: 2518 INDIGO DR Restrictions; NONE Restriction None Date of Births 4/11/1977 Supplement: Mailing City/State: IOWA CITY, JA Sex: M 522406808 History Information x ,ccir..a ffllt DateC %sga Illauirnbev Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 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: D. 0. T. ®` ......•. Office of Driver Services ,. Iowa Department of Transportation Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 ,,.. Dec.31. 1Flr ]{A 2014 9:27AM Div of Cr m nal CITY Investigation J• LV IR IV.'tImyl 41 Cf VSIy VI IVWA b I L y 9TATIE OF IOWA 1'�'/: ♦� Orihninal History Record ill 1': E'£ heck--- RequeSCIFO i To: Iown Dlvlslo)t ofCrilnfnnllav allgntloq Stq:l)oiwopernflon9buromt,1"Flow 11611.7'4 street 11osMoillu,folVa $0319 (615) 715-6066 (515) 715-6000 Wax i®ivcr°,Sigmalrare. NNo.8015 P. P 1. . U. DCT Accom)t Number: ............�'.... .. .......' tA[frt A4?�m Wonu C1TY Or IOWA CITY CITY CURICIS OrRTC 610 it. WASHINGTON STI8 a'1` Yfaono: 319-316-5061 Pox: 319-356.5697 NOW (ocloseOnly) � A5 of �° 7 a seawtt of the piovidcd name and d to of bi ih fotroaal®eS, No Iowa Crimlaal Astoxy R000x'd fOtlLA wJlll DCI rib Toi�aCa'It))1pallTist:)xyTtoc®t:clsxtllt®heli,FiCI# ®� .:. I i9CF Mills Received Time—Dec.3Q,-7414"10:45AM-"144, DecAl. 2014 9:27AM Dlv of Criminal Invest gation No.8015 P. 2/2 02 ARRESTED 19900902 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 .IA STATUTE IA713-6 ATTEMPT BURGLARY 2ND DEG TRK#: 037241001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA713-6(2) ATTXMPT BURGLARY 2ND DEG CHARGE CLASS: FELONY CONVICTION TRK#: 039241001 - SENTENCE DISP EFF DAT ,. COURT COSTS 19590226 PROBATION 2Y 15550226 - SUSPENDED 5Y 19990226 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OP IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TD NON—LAW ENFORCEMENT AGENCIES BY THE DCI, XN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD 18 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY, DIVISION OF CRIMINAL INVESTIGATION IOWA CRIMINAL HISTORY DCI 00507646 FELONY CONVICTION PAVE I OF I ' DATE PRINTED— 2014/12/31 DCIe00507646 NAME HAMRICK,CfIAD HAMRICK,CNADWICK AARON DON SEK RAC BUT WGT EYE HAIR SKN POE 19770411 M W $00 165 BRO BLK LGT° iA ADDITIONAL IDENTIFIERS CCH RECORD *<* 01 ARRESTED 19950916 AGENCY: IA0920000 WASHINGTON CO $O CHARGE NO— 02 IA STATUTE IA706-7 HARASSMENT TRK#: 022450902 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO— 02 IA STATUTE IA700-7 HAPABSURNT CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 022450902 SENTENCE DYSP EFF DAT FINE $100 19961024 02 ARRESTED 19900902 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 .IA STATUTE IA713-6 ATTEMPT BURGLARY 2ND DEG TRK#: 037241001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA713-6(2) ATTXMPT BURGLARY 2ND DEG CHARGE CLASS: FELONY CONVICTION TRK#: 039241001 - SENTENCE DISP EFF DAT ,. COURT COSTS 19590226 PROBATION 2Y 15550226 - SUSPENDED 5Y 19990226 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OP IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TD NON—LAW ENFORCEMENT AGENCIES BY THE DCI, XN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD 18 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY, DIVISION OF CRIMINAL INVESTIGATION