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Home My WebLink About14-125410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX FIMA't 1. Mame E, -"rt t" Authorization Number- ILI-126-- (Office Use Only) (Police Department review must be made between 8 a.m. to 3 p.m., Mondayd.: F)9 s �r"'"� i� .........................................................._... _. .............. 2. NI Address .,19 a � ��....ax�..I-.. ry ry......-.-.............................................................................. 3. Telephone: Home Other: (: (@ � � tY V V y 4. prllolr experd'e ra , iuv'tuanspol tatton cuff Vuassersgets� ,........,........ ' D f. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Ye� R ma„. TOWI .. 6. Have you bffnvicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? N 7. Have you been convicted of any traffic offenses in the last five years? (9 ptt..srff,cafift ru>r, tuI When ..... _....to2...,02-C................................................ __...................s.....�......9.......6 _C ..,................_......................................_....._....................., /� B. Has your driver's license or chauffeur's 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) (OVER FOR REQUIRED SIGNATURE AND NOTARY) ebad® 0312014 herebyrtify't �I�h�ae issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ' i I� . 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 r f p 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 ) COUNTYOFJOHNSON ) .. S scribed and sworn to before me by i ,,,,q ,,,' On this, day of Public in and for the State of Iowa 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). Signature i Ir or designee 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. Signature of City Clerk or designee ... ✓ l iDate Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/z" (width) and 5'/z" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update dwidtaWr1Nmdgaapp2g14.cc- 03/2014 Apr. 24. 2014 10:01AM 04iaei cv,tu vu:1G nna i ° n Div of Criminal Investigation 0 a 0 No. 8302 '� 3 DCI IOara, 0 STATE OF IOWA CrimiRal M'story Record Check A", FCUr Requegit Formu. 'rep laws lowbiow of cdediasi Kiwaltadw soppart appamdmamOor I' near 215 x 70 sitime (sikq wow Fam MW 41CI Aacoa nt Nu alez: „ f _ �^ t e Fromm phawa. Iimdf 33 rawa'14 38- N efn0A INa81fNwI*. ra,�°or arm: d8luear a .o.4 'amo' wadoaw 0iram Pia walhD or alae remgmral„ a rawrpWo ersmdaal butoryVaWrd MaJ m4ar The rdeamalrle Coda of lowau Ch"r 6ILL For skmvft odiabod, dei ory rw.MRu Badu adllon, am Munwad by paws mdweyo I?a'al&fp Aut &Iaraadv ow PnwMU% rep roa rer�aoamwr�rm y. ad�rv• dma .�il'�tl9� R..:�IV.ril� X81 .I��¢Dl'� �IlA4;�ld� a;Imr Gra.`Awaanmaum.Wd of, "fl a mooch of the provided none and daw of birth mveatodde .mal 1:3 No Iowa Criminal ffistomy Record found wilt DCI 10, I CHminal Maury Raxwd loaalr ICI a DC1 Wiiala, i ived Time Apl, 19. 2014 11:16AM No. 5809 Apr -24. 2014 10:02AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00518350 MISDEMEANOR CONVICTXONS ONLY PAGE '1 OF 2 DATE PR'INTRD- 2014/04/24 DCI:005:1. 8350 MAME: MRLSOM,SRIC VERNON DOH SEX RAC HGT WGT EYE HAIR SRN PON 19760605 M W 602 250 BLU RRO PAR IA ADDITIONAL :CDRNTTY:?I$RS PHOTO AVAI.LASLEY CCH RECORD **'* 01 ARRESTED 19960229 AGENCY: IA0520400 IOWA CITY DNIV SNC PD CHARGE NO— 02 IA STATUTE 24-40.1-3 POSSESSION/SCHEDULE IINUSHROOMB TRK#: 018655602 CHARGE, NO— 03 IA STATUTE IA124-401—ID POSSESSIOW/INTENT DELIVER MARIJUANA TRK#: 010655803 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE X9124-401-3 POSSESSION/CONTROLLED SUBSTANCE SCI% LE I/ MUSHROOMS COURT CASE ID: FECR40720 TRK#: 018655801 SENTENCE DI.SP EFF DAT DEFERRED JUDGEMENT 19950628 COURT COSTS 19960628 PROBATION 2Y 1.9960628 COURT DISP091TION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 02 TA STATUTE IA12C-401(1)(D) POSSESSION/ W/1MT8MV TO DELIVER/ WA91 A COURT CASE ID: PECRO40720 TRK#: 019655802 SENTENCE DISP EPP DAT DEFERRED JUDGEMENT 19960628 COURT COSTS 19960628 09013AATXOM 2Y 19960628 AGENCY: IA0520200 IOWA CITY PD CHARON No- 02 IS, STATUTE 1A124.401(5) POSSESS CO ROLLED BVESTANCE TRK#: IAOOIAO02 COURT DISPOSITION AGENCYs IA082015J JOHNSON CO DIST COURT COUNT NO— 03 IA STATUTE IAI24.4L4 POSSESSION OF DRUG PARAPHERNALIA COURT CASE ID: 06521 FECRO79267 CHARGE SS: MXSE)'EMEAWOR CONVICTION TRK#: IAOOIAO03 No.8302 P. 2/4 Apr.24. 2014 10:02AM Div of Crimiw Investigation SENTENCE JAIL 20 DCI 00518350 EPArE 2 OF 2 AN A"IRST WX"OUT DISPOSITION IS NOT AN INDICATION OF OUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION 18 A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO WON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISM . WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR TRQUIM DIVISION OF CRIMINAL INVESTIGATION m No.8302 P. 3/4 A�l %' J' 9w1YW VVV $ ryq �, $p"y q "reF iiwuww""�� .. @& ��N�'�W�R-.wduL ov (MM"s of rrtlrtV e r�rr e1, Pflaazrruo. 515-244 0124 �M 021"d:;i1 �f GM6,M...XM10t 'MMIN.duunnuxrcust.qw :Rnquuhy Date:: 6/11/2814 Nammm Nelson, Eric Vernon Address:: 1912 HANNAH 10 CT cltyj.qtate� IOWA CITY, IA 5224031 MallIng Addresin 1912 HANNAH JO CI Cerfiftel Abstract or, DrMing Remrd Hilsttolry linfolrimadon Customer M :BID S@altuum IDIL Status-. CDIL stat ms„ CDL Cart Statue. CDL Had Sttattum Restriction uSuulpppllemaimb Cttattldeun Dole 3Lre�raw &I'llon Datz A�cn S�uag�wnalil= . ...... ._.. ........ ... ......._ .a1�Y•._. ., � ,..... ..,..._...... 01/I16/2011I Speed i69/0Qli/1V',li1 V �; p " ° e¢h 119 uwiAlm 8. u3urate4 tlim :3.1-'55 uo71rollu zazueasx �I, ,,, ,' , , 2901696 None VAL None None None None County RA"'. rru�teuuh'Iatte 1,"a %Ymut,�uA�muu� Stw,IV�r " 3d 010 596007 !CA Name: Nelson, Eric Vernon DL/TD: 464KK6798 ,r �: +^M gal r, w W I MI F�� Office of M6/1112014 Iowa Depa of Transportation Class: D Audit 6011555 Issue Dateg 05/29/2012 Expiration Daten 06/05/2017 Endorsements. 3 Restrictionm NONE Date of Birthi 615/1976 Sam M Hilsttolry linfolrimadon Customer M :BID S@altuum IDIL Status-. CDIL stat ms„ CDL Cart Statue. CDL Had Sttattum Restriction uSuulpppllemaimb Cttattldeun Dole 3Lre�raw &I'llon Datz A�cn S�uag�wnalil= . ...... ._.. ........ ... ......._ .a1�Y•._. ., � ,..... ..,..._...... 01/I16/2011I Speed i69/0Qli/1V',li1 V �; p " ° e¢h 119 uwiAlm 8. u3urate4 tlim :3.1-'55 uo71rollu zazueasx �I, ,,, ,' , , 2901696 None VAL None None None None County RA"'. rru�teuuh'Iatte 1,"a %Ymut,�uA�muu� Stw,IV�r " 3d 010 596007 !CA Name: Nelson, Eric Vernon DL/TD: 464KK6798 ,r �: +^M gal r, w W I MI F�� Office of M6/1112014 Iowa Depa of Transportation