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Home My WebLink About14-249� 1 t "'Ill w® ® d CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319)356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) Authorization Number_ (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.) �' * °' ` . ** r�a^rraaff�� usaff ra�sraft f� ryaeradaC of ffae apta9�r�,pwtxrtzra 2. Mailing Address (REQUIRED) 3. Contact Information (REQUIRED) Email: et G � )q' � 1•CmxlCell Phone: `9 Jj-1 6�- 42 4. Prior experience in transportation of passengers: Mare45 T "�x A^;' 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ye< Tyne of offense Where whan 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Y 0 Type of Offense Where When 7, Have you been convicted of any traffic offenses in the last five years? VCS S hme of offense Where 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Tyoe 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 name(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIF ED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CI41ER'tRb*W You must apply for an individual Department of Criminal Investigation Report (form avallabltupolrFequmst). (OVER FOR REQUIRED SIGNATURE AND NOTARY) 0912014 hereb cri t t I have issued to me by the lava Depariment of 'i ranspoiiation a valid Chauffeurs license number 5 � 9 . i understand that if: falsely ansknter any questions in this application, that this application may be denied. I understand that fl' 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 albly 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 1 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. ([, asJAz to be sig -3d in frost" of a Notary Public) Signature of Applicant Y Date 1, YOU ARE NOT VALIDTO DRIVE A TAXI INI 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. .rkkkkkk#kkki-kk:khkk:Hekk3Rkkkkktkkkkk:Fkkk:Fkkkkkkkokkktkkk:Fkkkfrkkkkktkkkikkkkkkkkkkkkkk#-kktk#-Fk:H:kkkkkkkkkktkkkkk#k:ttkkkkkkkkkkkkkkkkk*Y:kkkkkkk***kk STATE OF IOWA ) COUNTYOFJOHNSON ) Tt¢scribed and sworn to bei 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). Signat CY Police Chief or designee Date 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. Signat eof City Clerk or designee Taxi cab businesses are required to provide Delver Identification cards. Cards must be 8'/Y' (width) and 5'/:" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update Clete/rAXIGRNBADGEAPPL92014amended.DOC 09/2014 Nov. 5. 2014 12:47PM lo/00/2926 10:24 FAX Div of Criminal lnvestgation STATE OF IOWA Request Tolaws DIVI[ don of cdodual Pav "aeries ,4aippaart Adana DO U, ldFour 215 E. 7°a Street WW Tdolul, laws $0310 (M)7254066 Q37 7R 0 Fax in .- l EM No. 3535 P. 1/2 DCI IDPA IA003 _II WR FIX: Daj3sRw X94 —. _ male emale 8 �6 �o�__ oaa. gyUab®uut Wwl�aWiH BNWflvnr tr0ea tone aata2t n� QQia rmgaaat, W aaaiPlara erlaalaafl hIuQOry it r W IanW a et the rtlaaaabla„ Par Code OVlowa, chaptWr692,2 For... _..a erlindual lalataay nrd IaH®rmaQCaas. as allowed by tlWw-, always FQdW�M � .ahmmpyaie�p6aw0�v' % 0am ai�wcrompsi�n�aa9 60 Dc aWbcla oda�laWWgdby 11W,xVtl$d IY�9aConeiiP tl vaeairaG�ill&pei6aViW4hiviarsgde4�n Ya iGeenzas i�9 91 sigan PrNQ w &.search of the provided mme nod date of birth revealed: No Iowa Criminal l Motory Record foxmd w hh DCN Iowa Cr` l Hist Record attaclQK DSD #--M.55-i-4 I)CII-77 (08125/10) r.; Nov, 5, 2014 12:47PM Div of Criminal Investigat;on IOWA CRIMINAD HISTORY DCI 00397552 9I0DXK9ANOR CONVXCTIONS ONLY I+AGE I OF 1 DATE PXIXTED- 2014/I1/05 DCI:00397552 NAME: OX&HffORD,JOr9L OTSWART 008 SEX- RAC HOT NOT 'EYE HAIR sw POB 19600415 M W 520 ISO BLU RED FAR IA 19600514 ADDITIONAL IDENTIFIERS CCH RECORD *** No. 3535 P. 2/2 AGENCY: IA0520000 JOHNSON CO SO CHAR - 01 TA STATUTE 111.3211-2 OWI TRK#: L37091701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEX WE INT OWI CHARGE SS: MYSDRMERNCR CONVICTION TRK#: L37091701 SENTENCE DISP E$F DAT JAIL 2D 19900125 FINE $500 19900125 CREDIT W/TIME SERVED SH 19900125 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, QUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RENEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THS ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION PURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL. INVESTIGATION 9 w,wk IInquulry lial Halmos: Address. City/Sial III[ IIIYI' III lu ui fii' ,, Il�lfl uuiiuirui� V l"/lltan.', fie Villa S1E^IV� NJ . E2t 121 4 / Bitu loll" Des IN/Ell lMPN�� I 55244,9 FAX: !1$15^239, 1 T.1~.t.1 Certified Abstract of Driving Record �IBSti Oxenford, 7oel Stewart 14749 KEOKUK WASHINGTON RD IM Mailing Addresm 14749 KEOKUK WASHINGTON RD Malling KEOTA, IA City/State: 522488594 101./IID •g„ 013664402 (IA) C1aaa. B Audit 4294361 Ess ue Dal 04/22/2010 lE:xpl sUan 11 04/15/2015 IEmdaaraemnantss: NONE Restriction= NONE Date of Birtlr. 4/15/1960 Sox. M Customer •1t; 495099 80 Status. None OLStatus. VAL COL Status. VAL COL Cert Status. Non Excepted Iblcifcal lEmanntnero II.(an le uµ Number Interstate COL Had Statute Certified Restriction None Supplement CIDL fMet imlExaminer's Certificate rx"m A!'w ientm Nlreatw�nrliro. ri�ed[cel t.xramN no Fil Nrrmr illedirali 1Exmanflinaau Last Naine. - sparks Iblcifcal lEmanntnero II.(an le uµ Number H056/1 ...., Mmflr.al lExamineu 3xisdirl10r° iI Modiuel FKauenlenrn..11 l?u,nr (319) 653-6601 IM^alli�r l E Wr,iard lYtl1"( f°GUf2" Q'llve �Q=aIY"0&"es Etedlaral Ca MElrawlm. lrxlae*d IDate 0 p04r.�yl, IhlrgdYrml a"euaotYrxteIf xall rElnun ICIh ^Ae� f �. u� Date Added to CD1111I S 11i ving ilernid i OrnQ112014 IfIIStory InfDlrmation 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 mstodfan of the records hold by the Office of Driver Services, that. this Is a true and accurate copy of an official racord currently in the custody of said Office, and that I have been authorized by the Drector of the Iowa Eepartmerft 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 ljr,/20114 Office of 111ffivar SeMces Iowa