HomeMy WebLinkAbout14-1171 a
1
CITY OF IOWA CITY
410 East Washington Street
Iowa City, Iowa 52240-1826
(3 19) 356-5040
(319) 356-5497 FAX
1. Name
2. IMaliingAddrem„ r,�2.6 + Z
3. Telephone: Home
Authorization Number /'4 _ 1) 'i
(Office Use Only)
APPLICATION FOR TAXI/MOTORIZED PEDICAB VEHICLEDRIVER
(Police Department review must be made
between 8 a.m. to 3 p.., Monday — Friday.)
4. Ilair'ior axpei,ienoe in transpoi,tat'oorn of passengers;
Middle �C
anther:
N VL)
5. Have you ever been convicted of any misdemeanors and/or felonies in this Mate or elsewhee?
6. Have you b en convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five
years? �
7. Have you been convicted of any traffic offenses in the last five years?
8. Has your driver's license or chauffeur's license been suspended or revoked in the last force years? A10
Tvoe 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)
dwWWwdnvbadg 03/2014
I herby certify that I hav issued to me by the Iowa Department of Transportation a valid Chauffeur's license number
�•f1 C t3 .-Y S- -7(, y. . 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 II of t e provi 'ons of Title 5, Chapter 2, of the Ci Code. Needs to be signed in front
of a Notary Public)
Signature of Applicant late_
-�
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 )
�._ o t... fore me by A .1aW ) , o �,�'---a On this . �f `x� day of
SubscSubscribedaand nd sworn o.be
.......r �
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).
- /-2-V --------------
Sigparture 77 Chief 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.
Date
Taxi cab businespes are required to provide Driver Identification cards. Cards must be 81/2" (width) and 5 1/2"
(height) and prominently displayed to all passengers.
Office Use Only
Approved application
DCI report
State certified driving record
Website update
derkftar:drwbeage pp2014 ace 03/2014
01
20.
2014
3:30PM
Div
of
Criminal
Investigation
IIII IVrd y.
IIII
III
IIRI
1).
[v it
7•L7 nil,
�iir
of
cin Vi Ly
V Lvru .0 i,y
0
STATZ OF IOWA
A
ny,CAMA081 Hutory Recokid Check
Yorm
JIw Towa.0frykionoQ4".rRirealww�a:lfon
Support dbpwerattozwm tuurearmr der Ploor
Dea 0/lotunw, fowwa 50519
(5115) 725-CO66
(5.15) 725-6080 Fax
1C&-7
NN?. 9200 PP. J/1
T1d9�da��awnrwxr, iaawu@ �a°.� —"_____.
Q�ra�pdRaa6Rey
tgr®lan: 'y m.t:Kgo
..City icker➢a°a OLftro
!-t tEL -1La1XtAtl1LLon StreB:t ...__----- ®_
6mrevavIYy YA S22'I0__________________________
MuOo, 31.9 11564 41
Fax: 319-19W "r,,.54917
jbe
WA[Ver.fromm $ane6objud oln' b ro-p%26 Aa da o*jad artrrAInd tntrtmrgr record MAY ]w
J?oY aoxw pate erNxajnjk history record) Iinfmrdnaffon, as wplo�reat by I W, %I Ny-x
alp ' eeledyra;fudwa
.taeros6. pdanODCO, My WWRd blooKy 14%wacumiA
IIs'' lyew i, uty ure
odhjInt rdlsdoxymmrd cheakwhh ARdaT;Ye YwYa a ofCx9R MA
Jek4iu tUawed by de.WB.
As of �" _ w a,se5rch oft D Provided a e 4nd dato ofbh'hrev wick„ i
C. r::' •.P :Ir •''!
No Iowa Cfuninal o1ry R ecofd fo ith JDCI T.,
:fowa arkain.alifdngyktecoxdaitaoh •DOI
DCI' '$'cls
Raeaiv d Time May.15. 9014 4:98A��Jo.01
�I
Riley, Bobby Joe
Address:
2502 BARTELT RD APT
Audit #:
2A
City/State:
IOWA CITY, IA
IExpiiN'atiion
522462713
IISsk:ec
IIN d Q'81r.^va Ilne IIAt u:
yu y^y ��'--!y��p-pp �'^�y��. y^$ �y^�, p
F d iW I/'Ili
VINI S qS 10wa AF.."V,p ��io
Status:
r I
¢g qq y p
S(c�'IA XER X 51PA' L:�
A
1, (�
I CUSTOM,, R
Office of Driver Sera ces
IPO Box 8204 Des Manes, [A 50,K b-9204
PlTone: b15 244-9$ 241 :,00-5212-,, *2:D I Faay... 515 239-1T37
Cer fled AbSVOCt Of Driivii-irg Illi rr1
Inquiry Date; 5/15/2014
Name:
Riley, Bobby Joe
Address:
2502 BARTELT RD APT
Audit #:
2A
City/State:
IOWA CITY, IA
IExpiiN'atiion
522462713
DI ID #:
690AI9763 (IA)
Class:
D
Audit #:
6909763
issue lllate:
05/01/2013
IExpiiN'atiion
07/21/2018
IISsk:ec
IIN d Q'81r.^va Ilne IIAt u:
3
Mailing Address: 2502 BARTELT RD APT Restrictions: NONE
2A Date of Birth: 7/21/1967
Mailing City/State: IOWA CITY, IA Sax: M
522462713
r;-
Customer #:
5937812
ID Status:
None
DL Status:
VAL
CDL Status:
None
CDL Cert
None
Status:
CDL Med
None
Status:
Restriction
None
Supplement:
1 IaN:FonIDOL& Convh'a air l AI911D IVttpa iwafion rocuulity JOiltlll't
0 /2;9,!'20P4 05f'07/2014 II47:4 Fall to Oha y Iutf C :!31g1�liJ!',.Nrl in Hr jublinsilin IIA
Name: Riley, Bobby Joe DL/ID: 690AI9763
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:
- °°°:Ylv 4
5/15/2014
I
). , Ta
N
^e®§' OBa )
Office of Drlvar . ge"Ices
Iowa Department of PY.angwrtadon