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HomeMy WebLinkAbout14-243410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) Authorization Number— a LlI (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.) �wrta/r�f?w_Wax a;��aax�6av��_))%s� °°f"fro9.aaanw�a�"" ��a%saua�?�af�rr ny�ctw(wrau�awdf�ra ��fPs�ad e��"(h� �ftr9d¢:�m�®gtrro Mailing2. Address 3. Contact . + 4. Prior experience in transportation of Phone: � r .. " ) r --,--)r y u 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years Have you been convicted of any traffic offenses in the last five years Type of offense Where Whr*n 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? � a; 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 CEIR(FI DRIVING RECO UST ACCOMPANY THIS APPLICATION FOR POLICE 0 I You must apply for an individual Department of Criminal Investigation Report (form available upon -rd uest� (OVER FOR REQUIRED SIGNATURE AND NOTARY) u:a 09/2014 I hereby certi that I pave issued to me by the Iowa Department of Transportation a valid Chauifaurs license number �/ 5 4 q c%/ . I undestand 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, lowa. in their discretion. to examine any and a41 records and documents relating to this application, and I further agree that, if a license is granted, to comply at all times with vll of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front cf a Nota.!y pul Ac? w Signature of Applicant,, 'W, Date2- C'".�_ ( If 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 ) Subscribed and sworn to before me by L®.+ c_en On this _1�2wrg day of I have reviewed this application, DCI report, and the State certified driving record of this applicant and have detar- mined that there is no information which would indicate that the issuance would be detrimental to the safety, heeltiA or welfare of residents of the City of Iowa City (T itia 5, Chapter 2, City Code). Signet ti Police Chief or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CIN UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'h" (width) and 5'/3" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update C!e?a7FXICdIV6:.93E???i57.CS?amarMoa. C<Y' 09/2014 °° om 2014 2 15P Div of Criminal Investigation IOct:21. IIII VL, I..F J. � IIII IIIII III IIIA III LV II MVI Ill LI,y U V'�ly VF lura U ly STATE OF IOWA i.O'1 Criminal History Record Check .. 7 Request Form To: Division of ati n Support operAdolls i Floor 215 E. 7" Sfrftf DmMofnesjowa 50319 t 1#I Pax NNo.J3927 PP. L1/2 U. From: MdY -T-4&N✓PA �Q,`.R�T ....._ _ �BIk�R. dbXRSA�re,� ��d_.. ,.... y YA 52140 .._...... ._......... Upwa ,,,,Cr'u storyll.ecoid. ;.he;l.............................. l:. �ncrusa Dllly� ds of /6 -e'Z ......./ o so oh of rheprovided.raamo and daM of'lolo h uwesle& ra No Iowa CrImftW Histoxy Reoord fouad with D CX Iowa Calminal History Record attarhed, DCI#—I. 1M. Received Dime"JcT023I1T014 1;44PM No. 2536 Oc°,27. 2014 2:15PM Div of Criminal Investigation .rx DCI ;00560300 NAME DUNCAlq,BCOTT KENDALL DOD SER RAC HGT 19591010 M W 506 ADDITIONAL 1DRNTIEI:ERS DCI 00560308 PAGE 1 OT.<.` 'I DATE PRINTED - 2014/10/27 WGT EYE HAIR SKN POE 140 BLU BEG MED PA CCD RECORD 0*# AGENCY) IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401-5 13089349SION/SCHEDULE I/MARIJUANA TR%K# : 031269401 COURT DISP091TYON AGENCY: TA052015J JOHNSON CO DIST COURT COUNT NO- 01 XA STATUTE IA124-40195) P099999 CON'TROLL80 S ST dH/SCHEDULN I/ MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#e 037269401 SENTENCE DISP EFF DAT FINE $250 19971121 COURT COSTS 19971121 02 ARRESTBD 19971007 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION/SCHEDULE I/XRRIOVANA TRK#; 037285201 COURT DISPOSITION AGENCYe IA052015J JOHNSON CO DIST COURT COUNT NO— 01 T.A. STATUTE I,A124••• 401 POSSESSION /CO • ROLLED SUBSTANCE/SCHEDULE I/14AR'IUUANR COURT CASE ID: 06521 SRCRO45809 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#e 037285201 SUBSTANCE ABUSE EVALUATION SENTENCE D'ISP ERV? DAT JAIL IOD 1.9980226 EINE $250 19900226 PROBATION lY 19900226 No.3927 P. 2/2 AN A"PST WITHOUT DISPOSITION IS NOT AN INDICATION MAINTAINED BY THE IOWA DIVISION 017 CRIMINAL INVRSTIGATXOW, MONmV 017 IDENTIFICATION ABSENCEENFORCEMENT AGENCIES BY THE DCl. IN THE OFmv, fm DIVISIONBASED ON INFORMATION FURNISHED. WE CANNOT 0014FIRM OR DENY '.rHX.r THE RECORD COVERS THE SVEkTFCT OlF YOUR INQUIRY. DOT �� :41���� ��� m,l ci .go office of Power somice"t I'D Ev= W04 q Des141s, IA. ""r03156-971.34 Pdigim 515-244.024 k 8019, 02-142 t pFay. 5V' ,230-1837 ::ram^Iw.i nuadr igovs Cae"tifled Alla lkll"'act of Il6fll"ist'in URarnar, IP'd Inquiry Date: 10/23/2014 Name: Duncan, Scott Kendall Address: 1131 3RD AVE APT 2B City/State: IOWA CITY, IA 522402013 DL/ID #: 713YY5941(IA) Class: D Audit #: 6416454 Issue Date: 10/25/2012 Expiration 10/10/2016 Date: lIA Endorsements: 3 Mailing Add 1131 3RD AVE APT 2B Restrictions. Corrective Lenses Date of mri 10/10/1959 Mailing City/State: IOWA CITY, IA masa: M 522402013 C=am Customer #: 3382468 ID Status: None DL Status- - VAL COL Statuso >,None CDL Cert ,,,',None Statua: CDL Fled None Status: Restriction None Supplement: ... .. _........... ... ....... Citation Date .... .......... ..... C::u':::lttlaan Date ..,............... AA'.`D ..................... ,.....—l– ................. dllelplla V'::t.lopn ............... ..... County .... :CRlllt 04/22/22..2 06/015/20U aH92 Spiced .. IYPowasIhick" lIA 1110112013 03/25/2014 M1.4 Falrco 011:l:y iii affic Slai::/Slrr:rl:u la:l:un:soIR lA , �Acii:ii drt;;!::'I: Date t",'arase II:W Hri Neo:IUR. dPP tltll'i,i�''Fi!Id'➢�NA:P '.59,546118 I1A Yljjgi I11111octhdo p:':d AR:CR t mpd.a::dvaUo:a Ciec'::a:'ence WR JUR ° spuar:9 r d"_* . .. 2 ,._.lY1-2­4d m ,d ,_1 ., ..l5,5 ..7...__ "N' i" °y, y,nm:.9. of v.ln.r.a...f. n: .._ A. .._,.. .. _,.. ,. I$p4 Name: Duncan, Scott Kendall DL/ID: 713YY5941 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: