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Home My WebLink About14-1191 N. ,, 6 - $ CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-54.97 PAX 1. Name 5 Authorization Number J Pow Cq I (Mice UJse Only) (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) EM 2. Mailing Address ._._.__Q_� -----� f V iy___ 3. Telephone: Home,_. _✓ u_%_ _qljz.,Other: ___ ---------- __------- ___------- _. 4. Prior experience in transportation of passengers: p ------------- 5. Have you ever been convicted of any misdemeanors and/or felonies in this Sate or elsewhere? jygp eRf.ofense 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? 0 a 7. Have you been convicted of any traffic offenses in the last five years? ypz a Egffnnsp Where oil UM .a ........................Y..'...y...... 'A'... s ......J..f....... �.......................................... ................................................ ...............................................d .......... ��.. �..��...��.. `..........................................................................: �Y.... �V.R............. " ,N.e"N...... ............... WW 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /✓® .-. r RM 9. Have you ever applied to bean Iowa City taxi driver using a different name? If yes, please provide the name(s) r• sj ZI 011T, 1111A FASisiel• 0 1 1C' •• (OVER FOR REQUIRED SIGNATURE AND NOTARY) `dnvbad® 03,(2014 q hery certify tha� I have issued to me by the Iowa Department of Transportation a valid Chautreur's license number 8 rt C 57— . 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 v www r"' a �_ Date�1� 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 ......... .. _ - R. dam. On this i "@ �:dre.. day of VVE'w>Y S, MA r p NotaryPublic in a for the Iowa x x�6wsd�Fa"af» ifl ;3 if �� C';creimlgaytnrr k usaA,w 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). !wOVA /ir rf�11►:a 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 —Aadte .._..:............ " Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 51/2' (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update derkftwddnvbadgeapp2014.d 03/2014 I0'ay.12. 2014 12:12PM Div of Criminal Investigation No.9746 P. 7/11 May. 7. 2014 4:41PM City Clerk —City of Iowa City No, 4680 P. 2 STATE OF IOWA Requeft Form WlAecountNbmbel•,..,.a . �g6'wa,MrNICww Vr� Tor TowabivlalonofCrJminA[lYeWe®llOatlon &kerne„ Pdyo$loyra &!gr Suppopt ®pprnllons cul°peer® J!"Noor City C: P.Vjea Office 215 D. V4 Street JU 0 �^'�P•astl lnatan .spa eek DesMotues,TowA 50319 (519),12-9,6066 oyda 4�ey, 1 522 0 ._ (6.15)125.6080 Fax Phonal 1.19,x,6041 AxI 5192.66-54 :I=re, uostdn aulowara,lugnatRidoz9Rs°urdC:taeokoxx RtN S9 mzwndnl ey} taA� �Jlk6 rrw a6wlm ¢bd�lA %C�AarrRA Crete irrucxvdw fb Date of DWI e...X .aO !"`v�elmel�l�ysanaPalolyD �..N �aai`A��)P.�acns .n �Jp�In�mrskyosC yre ern[�Poeed�e�ddy. ��WN �V�b �,n ® .° 4✓p C d6eJ6i�d%b Y tlJ171'�rrlll#� �4 �wA� � 1! qy � V �..']' Wd G�"ar$A'�r°.� �b>rdNr�l�ad0; 9ehdeut A AR IAeS vrAlvea° Orono t O'Auuh acd o$tlla rm neap! A aAxn �plp crgrelua9 g1lelo�°,y Yacar¢� IeaAy riot aoa¢uaA,rAblonpas^earloo$ma or4Dulupt�r692,2opea, op°U�re61eABhtsdnry yarer5lrfoxmlAfloarbArAlloyrclYnylaaawalways opr$atu a vra�ee^ aNa.:uA1�Ye Dram. CRao sugltq pok o$ phm a�equra�l, �. Al{�veP RBr86PS°8; Ihua®yglve permissionlN rhe above er�ue:lln� oMIaW Io eondu4'ail Iowa mfmrnel htslpgeeeurd crypcicwllh Ihpblvision o£Criminal ynYr$lippllbR (DG'n, Any almina(rdrlory dalaepACt@Iqg AlolllellrinpinlAfA�aylho AClm�1°berolepgadatelloWad By laW. "sr�vr�•P�"�5°ra�e>etua^�1_ ..m�, v /' �+'�� 4. �� ,� As of 0 s oia o'(r,Iao prov1ded.nunB arbd data o 6a1y2b xovaatnad t No Iowa. Qdminai Mdoxq Record Pound with DCI Iowa CrhnWI Matoxy Record attached, DCI,::,:: • r p 'd�Q:I.alan�al May. 12. 2014 12:12PM Div of Crim nal Invest gat on :KOWA CRIMINAL 'HISTOR'Y MISDEMEANOR CONV:QCTIONO ONLY Del 00370225 PA016 1 Ods° 4 P A"%M P'.RINTEC 201,4/05/'3.2 DCI:00370225 NAMES BAN9,THOMAS DANIEL BANS,TOX DOI.) SEX :RAC HG:C WGT EYE HAIR U: xlq POS 1.9490,112 C2 W 53A.. 1.75 HRO RIX :1'AR, IA ADDITIONAL IDKNTIFIERS CCH RECORD 01 ARRESTED 19871227 AGENCYz IA05202DO IOWA CITY PD CHARGE NO- 01 IA STATUTE 7:A123 ,46 PUBLIC xftox TRK#: L33479301 CHARGE NO- 02 IA STATUTE IA719-:1. INTERFERENCE WITH OFFICIAL ACTS •� TRK#: L33479302 CHARGE NO- 03 IA STA".CUTE ZA.723-4-1 pxSORDERLY CONDUCT TRK#= L33479203 COURT DISPOSITION AGENCY: YA0520151T JOHNSON CO DIST COURT. COUNT NO- 01 IA STATUTE IAI23.46 CONSUMPTION / INTOXICATION - 1970 CHARGE CG Ss MISDEMEANOR CONVICTION TRK.#: L33479301 SENTENCE DI,SP" Y:7Y'PP DAT PLEAD GUILTY 19871227 FINE x$25 19871227 COURT COSTS $20 1.9872227 COURT DISPOSITION AGENCYe YA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA719,1(1)A INTERFERENCE /OFFICIAL ACTS CHARGE CLASSs MISDEMEANOR CONVICTION TRM L33479302 SRNTENCE. DISP EPP DAT PLEAD GUILTY 1.98711.227 FINE $10 19871227 COURT COSTS $20 19871227 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE IA723,4(1) DISORDERLY CONDUCT ^^ FIGHTING OR VIOLENT BEHAVIOR CSARGE SS: MISDEMEMOR CONVICTION TRK#= L33479303 SENTENCE DISP EFF DAT PLEAD GUILTY 19871227 FINE $10 :09871227 No. 9746 P. 8/11 May.12. 2014 12:12PM D v of Criminal Investigation DCI 00370225 PAGE 2 OF 4 COURT COSTS $20 19071227 02 ARRESTED 19890.507 AGENCY: YA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INEOX TRK#: L31479401 CHARGE NO- 02 IA STATUTE IA714-2-.5 THEFT $TO D:E9RBM TRK#r L3.:347.9402 CHARGE NO- 03 IA STATUTE IA719-1 INTERFERENCE WITH OFFICIAL ACTS TRK#: L33479403 COURT DISPOSITION r AGENCY z :TA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION - 1978 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#; L33479401 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $20 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT .COUNT NO- 02 IA STATUTE IA714.2(5) r THBFT STN DEGREF 1978 CHARGE CL Ss MISDEMEANOR CONVICTION TRK#= L33479402 SENTENCE PLEAD GUILTY FINE $75 COURT COSTS $20 COURT DISPOSITION AGENCY: IA092015a JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE IA719.1(1)A INTERFSR C /OFFICIAL ACTS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479403 - SENTENCE. PLEAD GUILTY FINE $15 COURT COSTS $20 03 ARRESTED 19920607 AGENCYg IA0520200 IOWA CITY PD FA i9 I V No.9746 P. 9/11 ,May,12. 2014 12:12PM Div of Crim nal investigat on DCI 00370225 PAGE 3 OF 4 CHARGE - 01 IA STATUTE IA321J-2 OWI TRK#: L33479501 CHARGE NO- 02 IA STATUTE 1A204^401-3 POSSESS SCHEDULE I/ RZMMA TRK#: 1.33479502 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204e401(3)(B) FOOS9201ON OF MARIJUANA CHARGE CLASSY MISDEMEANOR CONVICTION TRK#: 1,33479501 / SENTENCE DISP EFF DAT 1/ JAIL 1D 19910026 CREDIT "/TIME SERVED 7H 19910026 COURT DIOPOSITION ENCY: lAOS2015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA321J-2 OWI CHARGE CLASS: NOW CONVICTION TRK: L33479502 SENTENCE DISP EFF DAT bEEERRED JUDGEMENT 199/0926 DISCH%RGHD FROM 1.9920020 DEFERRED JUDGEMENT 04 ARRESTED 19950226 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION -SCR I TRK#: 014619101 COURT DISPOSITION AGENCY: IA0520159 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-204.-4-M POSSESS MARIJUANA CHARGE CLASSY MISDEMEANOR CONVICTION TRKY 014619101 SUBSTANCE ABUSE EVALUATION SENTBUCE DISP EFF DAT SUSPENDED JAYL 30D 19950330 RINE $250 1.9950330 COURT COSTS $75 :5.9.950330 PROBATION 1Y 19950330 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA665®4(2) CONTEMPT OF COURT 0 No. 9146 P, 10/1 may. IZ. zvlq N: 12N Uiv of Uriminai Invest,gation I" 4*1 No, 9746 P, 11/11 DCI 00370225 PAGE 4 OF 4 DISP EPP' DAT 19980915 Aff ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECOO MAINTAINED By THE IOWA DIVISION OF ClZjr4'NA'� 19VESTIGATIONv BUREAU OF IDENTIVICATION IS A PUBLIC RECORD BUT CAN ONLy BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGER VASED ON INFORMATION FURNISKEDWW* COVERb THE SUBJECT OF YOUR INQUIRY. AT *IVISION OF CRIMINAL INVESTIGATION I I DOT CUM caffiriyel�:S�rvie�ktta P+0 Lb'N9'.'&. iY.Y". J4 �.U. es P2161C¢WP , ill.. t'ikk.if1C+:.02M ff'#mm 1.A&244-91.24 f SM -532-1121 I a1 .5 t , 239-18SI WnatC4.It bYe"adl atL'Usm Certified Abstract of Driving Itecord Inquiry Emne 5/14/2014 DL/ID #s 251CC0152 (IA) Names Bane, Thomas Daniel Class, D Addresses 5038 AMERICAN LEGION RD SE Audit #s 5992342 IA James Dates 05/18/2012 City/ IOWA CITY, IA 522409070 Expiration Dates 01/12/2016 endorsemaDibe: 3 Mailing Addre sm 5038 AMERICAN LEGION RD ,SIE ftestrIctiossug Corrective Lenses Days of Bluth: 1/17/1969 Mailing City/ tae IOWA CITY, IA 522409070 M IMlstovy linfortwation RM to Obey Traffic 5 t Belt violation Aaa,M1aimwuna IYI-.fir; Camrvt Eurrifter Gid$t."ro/".kOAI ..... . ......... .. ,&Ua 1ro11 m ........ Name. Bane, Thomas Daniel 11i 2.51CC0152 4289265 None VAL None None None None County :lief: Linn Yp !Linn =IA iIA—� . lnhn.on IA 'lohnson IA JWP. Pursuant to Iowa Code §321.10, 1, IOm 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: 5/14/2014 Office of Driver Services Iowa Department of Transportation Names Bane, Thomas Daniel DL/ID: 251000152