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Home My WebLink About14-225t ►'III h � 1 e OIL CITY OF IOWA CITY 410 East Washington Street Iowa City, lona 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name (REQUI( E'D) _ Authorization Number —1 (/ /"rte/ tq (Office Use Only) APPLICATION FOR TAXI I MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday -• Friday.) I' dllurea fo comefa6 iw- d1 ..°`. slgdri EL Inforra(arwill r'll n denial ...e, actfi,ldl. ...,twpapla,�; r fiesrr TIle r tL "ossaAA Md C 6wAA Cell Phone: re -471% 1 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense 1) (at9 i ,d Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? c1 U Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? ® Jij 0 Type of offense Where When 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? /)0 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 the name(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIEMg DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEN t rD w You must apply for an individual Department of Criminal Investigation Report (form avallabl2 n w aluest • t (OVER FOR REQUIRED SIGNATURE AND NOTARY) '''' —4 te 0912014 I hereb cehat I ��ay, ,iss,,Qpd to me by the Iowa Department of Transportation a valid Chauffeurs license number p "w` ani 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 lokaa 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 2o'.aa signad -in front of a Notary Public) Signature of Applicant 19 pr -r" Date ® C 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 vnrebsite at lcgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by we nl e A On this 1 day of <®*^ UAI s— 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). l(4/2U1� Signature is iefordesignee Date YO 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. Signa�of City Clerk or designee le, 7 ✓/� _ Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5'/i' (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update OmWrAXIDRWADGEAPPL9201a mended.DOC 09/2014 Sep, 4. 2014 4:58PM Div of Criminal Investigation Avg 11. IV 14 1 : ) i rivi City 6 ( e r K WEY OT 1OWa ULY NO. � No.94I qu 1P,P. 2 P. 2/4 STATE OF IOWA .... .. .... QrWnal History kecq� d (Check Request Form Ml Account Xurnbet: To; Iowa Divislon of Criminal Investigation Support Operationa Burman, P Vloor 219 X, In' Strect Des Moines, Iowa 60319 (916) 7M.4069 (515) 725-6080 wax From® Cwof awa C !'Y . .......... 1 .4y—.. City ryerk!a Ofte !t.4.13.Y�J'�! N PAt. m.'9—t r..", T 6 A 5=40 .....1.............................................. . . ..... Phone: 319-150 5041 raw.. 319-356-5497 Iowa Criminallil..s.t(.Wr.V"IIR.ecord Check Results .......................................................................... .. . . .. ................. .. ............................... (DC1lbe only) .Aa o�f_..w q a search of the provided narne and date of butte revealed: w No Iowa, Criminal Mtory Record found with DCI ivIowa Criminal History Record attached, DC -T. 4 9.1.2 -to- we p. 4. 2014 4:58PM Div of Crm j nal Invest gat on Dci 00491790 PAGH 2 OF 2 AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 TA STATUTE IA708.2A(2)(6) DOMESTIC ABUSE ASSAULT WIT90UT XNTRNT CAUSING 112d:YORY COUR:r CASE IDa 07701 AGCR.026.983 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: M00167401 SENTENCE DISP EPP DAT TIME SERVED 2D 20030819 SUSPENDED JAIL 60D 20030819 JA.III,, 62D 20030819 FINE $250 20030819 PROBATION IBM 20030819 AORNCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA 3TATUTE IAI..24.401 (5) POSS CONTROL SURSTANCZ '..IY TRK#: 101070401 AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124,401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE Iii: 06521 SRCRO97657 CHARGE =SS: MISDEMEANOR CONVICTION TRK#: 101070401 LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT SDSPEI+YD$b JAIL 30D 2004.01'��',14 JAIL 30D 2004051.4 FINE $250 20040514 PROBATION lY 20040514. COMMUNITY SERVICE 25H 20040514 AN ARREST VIXTHOUT DISPOSITION V-.1 NOT AN INDICATION OF GUILT, THIS RECORD INTAINED BY THE IOWA DIVXSXON OV CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI IN THE ABSENCE OF FINGERPRINTS FOR POSITIVR IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD VERS THE SUBJECT OF YOUR QUIRY. DIVISION OF CRIMINAL INVESTIGATION "1 No.9412 P. 4/4 Iowa 1,'Yc--tPartP.,nent of 03hee of Onver �emces I loll Free) X300-532-1121 PO Box UK Fles Moinos, LA, 50396-1:1204 51&-244-9124 FAX� 515 239 18W Name: Maeglin, David Otto DL/ID: 059BB9825 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 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: ""Ili 8/27/2014 V " R 0. T. Office of DriverServices Iowa Departmentof Transporadon Names Maeglin, David Otto DL/111): 059BB9825 Certified Abstract of IDirliviling IReooid Inquiry Date: 8/27/2014 DL/ID 059BB9825 (IA) Customer 1387263 Name: Maeglin, David Otto Class: D ID Status: None Address: 2038 DEERFIELD RD Audit 5187550 DL Status: VAL Issue Date: 04/28/2011 CDL Status: None City/State: MUSCATINE, IA Expiration Date: 12/11/2016 COL Cert Status: None 527618329 Endorsements: 3 CDL Men Status:, -':'None Mailing Address: 2038 DEERFIELD RD Restrictions; Corrective Lenses Restriction /'None Supplement: Date of Birth: 12/11/1959 Mailing MUSCATINE, LA Sex: M City/State: 527618329 MstoiryXinforimatilon Name: Maeglin, David Otto DL/ID: 059BB9825 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 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: ""Ili 8/27/2014 V " R 0. T. Office of DriverServices Iowa Departmentof Transporadon Names Maeglin, David Otto DL/111): 059BB9825