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.)
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Mailing2. Address
3. Contact . +
4. Prior experience in transportation of
Phone: � r .. " ) r --,--)r
y
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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
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Criminal History Record Check
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Request Form
To: Division of ati n
Support operAdolls i Floor
215 E. 7" Sfrftf
DmMofnesjowa 50319
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NNo.J3927 PP. L1/2
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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.
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office of Power somice"t
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::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: ...
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Citation Date
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C::u':::lttlaan Date
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03/25/2014
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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: