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Home My WebLink About14-171410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name 3. 'Telephone: Home Authorization Number 114 _ ri I g s (Office Use Only) i Wur� fY1 YItY� 7ur" L I ire %j (PoliceDepartment reviewr�.dbetween 8 a.m. to 3 p.m., Monday — Friday.) - IMdd -_________----------_p°A ---- D_--------- --------- ILast _P ��i'S' l p"(✓p 'Ca(i(GrLe✓ �1 �'�'+�;r� Ci4 Oftr: 4. li5rior experience in transpoftflon of passengems:%.,f e .� rti __-------- -- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? r- 7 Have you been convicted of any traffic offenses in the hast five years"?°�' Whemc S. II Ns jour drivee"s kense or chauffeur's license been s 's—p *Tidedor rc-i Eked in the last five Log—of offense Where kmm When A � 6o am 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) (OVER FOR REQUIRED SIGNATURE AND NOTARY) derkftddnvbadg 03/2014 hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ;„F - . [")D 7D 4 f . 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 Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date,_ m R) 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 ) to before me by Mgn�P 4-g 4A vjo a &,215�a On this _ O ' -j day of Nuns Pr 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). Signatu of P Chief or designee Datr: 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. t� Signature of City Clerk or designee �IN / ' .. . " — ------------- Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/:" (width) and 5'/z" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update Cork idrivbeaaeapp2C44.doc 03/2014 Celrtiiffled Abstract of IDirriving Record Inquiry Da't'm 8/13/2014 DL/ID DO01/II Mahar° Hassan, Mohamad Awad 5M A, RTER 1 013TW O 2769 WHISPERING MEADOW Audit #: 7921154 None .MwNFLEF Issue nate° .,"ov Office out 01"ArnaselY ocos City/state: IOWA CITY, IA 522406847 Expiration Date: 01/16/2017 PD Box ?4"M4 „ l tft l!f'llanl nm, IA "nDt�'.fDf&»-4D7:IYU Endorsementm 3 )" kinc. 5'81'6 Cr"f 1 ?BD.P41'k#0¢E'1:b2-°8t2f1' II I = b9„"s 7;W-D8,Ae NONE DR Iiiate of Rlrth: �trywlrww.uieb�luaaDuaD.c)a�ia Celrtiiffled Abstract of IDirriving Record Inquiry Da't'm 8/13/2014 DL/ID 26IDD7091 (IA) Mahar° Hassan, Mohamad Awad Class: D Addrarm 2769 WHISPERING MEADOW Audit #: 7921154 None DR Issue nate° 03/26/2014 City/state: IOWA CITY, IA 522406847 Expiration Date: 01/16/2017 ,..�.. .... ...... fll '. Endorsementm 3 Mailing Address: 2769 WHISPERING MEADOW Restrictions: NONE DR Iiiate of Rlrth: 1/16/1986 Mailing City/state: IOWA CITY, IA 522406847 sex: M Customer M 4640700 ID Statues None PAL Stature VAL CDL Status: None CDL Cart Status: None CDL Med Status: None Restriction None Supplement. 64 611 112013 Citation Daam. Cvsnvaus.+C4rauw Date ACIDP .......... ,....................... ..... ........ m. vel lainatioln P .......... ....... ......., Comity JUR (HwC a/2010 __. u N123/20 V flD ..... S92 'Speed (I0 mlphi & amid¢ i in '35-55 lnnliillul zo ve) Cllavhnsevinl 0�I/21/201.2 Q17/1 IM1,4 Fd i to41ia¢.Y 11 r¢rfrl'ii¢: BuAn,6°:tl¢pavai ... .. .. ...... 30nson 11A 64 611 112013 QDB/1QU/2013 i93 ;Speed ,..�.. .... ...... fll '. 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; ,,' 'n, 10 I,, DriverOffice of Dep.rtment of po 11111111111111111111111AAug.18. 2014 12:48PM CDiv of Criminal Investigation IVIIIIII I y 1111111 111111 UW rSTATE OF IOWA A " 1 L 1111 a i iy Iii 1 ill Request Form To: Iowaa Division of Criminel lnveatigaflon Supp ort Operations Bureau, l" Floor 215 E. Ira Street D6il Moines, Toi 50319 (515) 725.6066 (515) 725.6080 Fa'k NiI2631 P.P. 1/1 DCI Account Number. y�1 (ifappiioehio) From: City of lowwa.d:IGL............................................................................... Clf y C lhOes office 4:1O Jit, Vfdfrslagrt 7 fll. Street lsouse City„ IA 52240 Phone: 31.9.356-5061 II 3:I9.:35Fs..5197 C.asttt.z'c... cstittn ............... lrswrY i 9srttaan tl I,Instnay Baeccrn I (lueolr.. ansn: si.._.._..... ................ ._._.._........................................................I........._..._.. ._... .. ........... T., astar&9 ist Nane tnanCamvMiddle qxartirnrinw) .......................................................................................................... .......................................................... unlaw ..-Date...ofBir t)14�g�o�waadmimrrb":B_.,,.... � (w"otwd1•d"I"Nmndairih Socis_I. dt'�a,ft Y�'ftA��:lie'I"luwcoagoxea'ano9odp ,f ale OFieaxfii➢.e C i0 ..... ..............................._..._...........�...._._............................... aiairwses^ has a Pnaaf/aaus; ltJiithou t ra ei rued a� 2lvd ¢° f't-om tion: auly ed of the request, o corlar Mete gaThAtt urel history record may not .....__.. be releasable, per Cade,arflnwwa, Cimpten° 6'92.2.Ndor a ars nlai�.te criorinnal Ih(islow:v record hdaarenatloana us allow ad by lonwu olwa,p obtain as vveiiver si nnaturc from, the subject of the re uesl Waiver Tnveatigation (I)C1). Any eftunal history data coneerm ig mo that ir meinleined by din bCl maybe reieaud as nllowmd by law. Sky(livFI^, u"9alorturk.............................................................tet, gym' .............................. ¢ ..... ........ .,....�................................................::................................................................................................................................................................................................................................................_.._... �tl lqlva Criminal As of S- ... ` a search of the provided name and dose oibixrh xevealed: = i No Iowa Crir deal History Record f6i with DC1 r Iowa (dmhal Histwnmy Record lai'.te v.et1„ DO# ............ ................. DCHnitiais �I^ ir bCT.--77 (09/25/I0) Received Time Aug, 13. 2014 NON No. 6937