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Home My WebLink About14-227t "'III Ron CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 3S6-5497 FAX 1. Name (REQUIRED) Authorization Number__" \ (Office Use Only) co 5 4}C1 APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday— Friday.) _.:..............._........................... . _ .. _ .`.`......-ad _ ." .. _ ............._...........__.................._.:. ".............in e.j.1aaf of ff7r. �ai�p(aL� (epr) _.... ar etro r7 com ..... Pl p e rn> ulr� cf" h7forrnat/ora will re lilt f ................__..................__ ............ 2. Mailing Address (REQUIRED) C 3. Contact Information (REQUIRED) EmaiI:fLLqC 4. Prior experience in transportation of passengers: Phone: a4lAd—f--!NZ 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 5 Type of offense 6 When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Tvoe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Whe_r.e 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five Where When 9. H2vp VWLI w DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an Individual Department of Criminal Investigation Report (form available upon request). (OVER FOR REQUIRED SIGNATURE AND NOTARY) t' r r I hereby certify h Al a e i sued to me by the lovda Uepartnent of Transportation a valid Chauffeur's license number r z 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 itle 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) _ p Akllli Signature of Applicant 9�°r Date :.I' V, �' 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 ) and sworn„ to before met'_)rA,6 jL On this t. - . day of 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). 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. Signatke_of City Clerk or designed' A... ®e.� Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 6 %" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update cleiWrAXIDRNBADGEAPPL92014amwded.Doc 09/2014 §2 , -i', °�i 1011./ID D:: p� p 0� Dy01u, Customer ON p�DO Nelson Mofadden, Matthew Duff �,P gawF I� �p ,}�� p �pp� 4 ryyA, M��w4,d �M�N!pm��.��WAr ��ta•ii� -^a f Yw�"'��:��k �Y'MPA'��a�� 1000 CHURCH ST Audit 1In 2x Off r -a of I,IhtvtOSeNvif w::rna.PoYi Di. Status. VAL X''"tP nax sd!'0' a Tum pa)0a&leg7 , IA !9=6402w Issue Date: 02/14/2014 i "d :n 51 tri;.^44 91'74 p>fkdl6p 632u 1121`& I ax' �I w154f,30-1831" None City/State: ... - w�mrarw'rom4,:f::tal/aa Cartiitued Abstract of (Driving IResc Drd Inquiry Datei 10/7.4/207.4 1011./ID D:: 960AA6621 (IA) Customer ON 16329.36 Nelson Mofadden, Matthew Duff Class: D ID Statusn EXP Address: 1000 CHURCH ST Audit 1In 7792149 Di. Status. VAL Issue Date: 02/14/2014 DIIDL Status. None City/State: IOWA CITY, IA 522456011 Expiration Date: 02/14/2021 CIDIL Cert Statau.su None Endorsements: 3 ODI(. (Ned Stataum None Melling Addresin 1000 CHURCH ST strictions: NONE IReatrlctleun None Date at Birth: 2/14/1977 Suppllament: selling City/State: IOWA City, IA 522456011 Sex: M 0ta"Ga Date canOttkio Date t isbalry 1rifDlrmation mm 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: DIOWA 10/14/2014AOffice of Driver Servicessolo Iowa Department of Transportation Name: Mcfadden, Matthew Duff. DL/ID: 960AABS21. Oct. 6. 2014 1:02PM Div of Criminal Investigation ly®GLB LVl7l tVaVl ! g ygp �/ �h/I I III III ��U III I I� r RdAlb I�� N li III J" To 99we Mwlsba oP AmdNrnm %w wflgaNNaaaa auQ pop OPWAHUMN Bwemuud 'N0 pber 2:IINN 9, Dam rower Des MoN ,Iowa 503M9 hysm ,Y (515) 72 O Fox 0M o DCC IowtNo. 2058 P. AA (ir.pprivablo) From, .... aalraala"Ii,,,aauN...................................... �..... M.'I � IiMevey� 'Nlaael (319)331,8294 9 sk.N. nId...,, � s-st ip t. iM 4111ror without a 1%ned vweNven° from the eaa Teed of khe request, IN vwwwm kke a'wa°Nru+aIM bNedoay Ireee7N Imeey auoe be urele ele4e., Iser a[".mide oflovvi4 Chopler6912. For I..gl, dlN,t euImdla W h1 daary la•e vat Iauffon°evue06e6 889 291WGd Iay Mew+a ulMvrnmpre ORM48lua a wolves eI' oodaamL Ilhema khe eduln a m1M R•r aaeel adverRelR:ase, tlI anUvropa"rwa aer,u;ucUnora Pareei;mna'oae nrw�raead'4aneamdeaiauae emaw�'uasa uta¢rpar�mWflualY6e�l VrlaaasWq�aawm�eUweck fl IIAa'e Alow rwa"8.mtiwn&nwN Uuau+ dueanCava QWp,. Any sxnewawd dy%'adOw*ease rmNmuna llwxe Mn ew " a bug,Ifnm uswmg be talwad Ilan Mo ww by 9gow.. No Iowa (:"simbzrd R°aia yelaoidM ..found vwMd7d,M)(.3 W.ow a Ulrptlavaml History Record onw hed,'DCT fM..... ... dkz IM -77 (MV10) V Received Time Oct. 2, 2014 10:30AM No. 1855 Oct. 6. 2014 1:02PM Div of Cnm nal Investigat.on IOWA CRIMINAL HISTORY VCI 00564967 =SP MANOR CONVICTIONS ORLY PAGE .1 OF 2 DAM ARINTED- 2014/10/06 DLa�ISTD,�HADDeD MOFAbD=,KRTTflRW DUFF SHADON,11PLORISTO R R 'DLORISTO JOB SEX RAC PSO"%i WmT EYE HAIR SKN POR 19770214 M W 601 175 HA2 ENO FAR CA ADDITIONAL. IDENTIFIERS CCH RECORD *** 01 ARRESTED 19571114 AGENCY: XA0520400 IOWA CITY UNIV SEC LPD CHARGE NO— 01 IS, STATUTE IA713-5-2 BURGLARY 2 D ANE TRK#: 019696601 COURT DISPOSITION MENCIa IA0520151T JOHNSON CO DIST COURT COUNT NO- 01 1A STATUTE IA716-7 TRESPASSING CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: -010405601 SENTENCE SAIL 26D COURT COSTS 07 ARRESTED 19991130 -AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA124-401 P099 OCR I — MARIJUANA TRK#: 047944901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT RO— 01 IA STATUTE IA124.401(5) POSS43310M OF A CONTROLLED SUBSTANCE - OR CHARGE SS: MISDEMEANOR CONVICTION TRK#e 047944901 SENTENCE JAIL 49H FINE $250 COURT COSTS LIC REVKD 03 ARRESTED 20000627 AGENCYu IA.0.520200 IOWA CITY ASB CHARGE NO. 07. IA STATUTR IA700a2-3 ASSAULT WMLS DISPLAYING DANGEROUS NVAPON TRK#: 053311601 COURT DISPOSITION 0 =R EIRP DAT 199712.119 /9971219 VX5V EFF DAT 20000530 20000530 20000530 No. 2058 P. 2/3 rrr- Oct. 6. 2014 1:02PM Div of Crimina% lnvestigat�on f JOHNSON CO DIST COUR COUNT IINTENT T O CAUSE FAIR OR 3+ COURT CASE ID� 06 CHARGH CLASSi MISDEMEANOR CONVICTION 053311601 1 SENTENCE DISP EFF DAT FINE $1,2.5 20001107 ARRESTAN MAINTAINED BY THE IOWA DXVXSIONON BUREAU IDENTIFICATION IS A PUSLIC UZC0413 nUT CAN ONLY EE RELEASED TO NOR -LAW ENFORCXWlENT AGENCIES BY THE OCT. IN THE ABSENCH OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD EASED ON rNPDXNATIONa O COVERS THE SUBJECT OF YOUR INQUIRY,DIVISION OF CRIMINAL INVESTIGATION I P.� mrd'