The URL can be used to link to this page

Home My WebLink About14-0841 r CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name 2. IMailing Address kWt�brizafion Number l q— Vy\ (Office U e Only) Departmentr, between 8 a.m. to 3 p.m., Monday - Friday.) Iiiddle ILast 0A �0 U4°b ANA VtAi 3. "relephone: HomC.__?10,_Ltt __d_�A!?______ Other:.-? 1"101_ 5 4. Prior experience In transportation of passengers .. . ___ `—_ti°:?_______ ------ — ----- —_____ 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? t,1 (S um 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? T e of Offense Where When 7 Have you been convicted of any traffic offenses in the (last five years? "< a........................................................................................... Wr�'hen ........................ 8. Has your drivel's license or chauffeur's license been suspend d or revoked in the last We years,? y e 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) //'r, (OVER FOR REQUIRED SIGNATURE AND NOTARY) de1kft4dnbaass 03/2014 I hereby certify that 1 have Issued to me by the Iowa Department of `I"ransportation a valid Chauffeur's license number 1'�� -Y 1r.., "..1 5`) . 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 appiication, that this application will be denied. I agree that in making this application, ! 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 sigrad in front of a Notary Public) ' = X sti Date 5 / ?� f I 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 (worn to before me by " e _ V ....... On this _'d: day of 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). Sign of Pof a hief of desi g ---------- _.___ 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. y s r� Signatd1re of City Clerk or designee ._./ 14 Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5 %1' (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update eerW4vddr1vbedSe�pp2014.doe 03/2014 � I %f0grr�' No M 'D0T l" M I'f I ; � � C U i p 5 v�, r rli s. k�� , y4 wumwwavv eo�nsan T iomow�wuwmow. Wcs QIP Driver setylices PC) Box 92,04 [NIs t/(irbwl*.e"A<, A (Zf)i0t»-d..2.04 r Inquiry Data: 3/26/2014 DL/ID #: 713YY6075(IA) Customer #: 431346 Name: Adams, Adli Daoud Class: A ID Status: None Address: 2608 BARTELT RD APT 2C Audit 4078525 DLStatus: VAL Issue Date: 02/05/2010 CDL Status: VAL City/State! IOWA CITY, IA 522462730 Expiration Date: 01/01/2015 CDL Cart Status: Non -Excepted Intrastate Endomements: LNPT CDL HadStatus: None Mailing Addrawsg 2608 BARTELT RD APT 2C Restrictions: Except Class A Bus Restriction None Date of gUrth: 1/1/1959 Supplement: Mailing City/State: IOWA CITY, IA 522462730 Sex: M History Information Convictions r---'�----- �Citsatlon Date ...... Conviouaon Date _._ >1CD .----------- lulplanation _--------------------------- _______ ....... _....... .,...__""'____._.�...-._.._ County .Itll" 112/05/20:1.0 .02./18/2071 M40'Improper , ._ Signal or Failed to Signal :Iohnson ... IA _. 09/29J207I ........ .MIA iFail to Obey T'rafYlr. SiWSignal Johnson ',IA _...... 0I/04/2013 01/28/2013 MIA_ Maul tet Ohay irafflc ',.rgqur/So®nal_ Johnson 'IA ',. 02./21/2014 E03/20/2014 iM14 ,IFall to Obey Trafffic SfgwpSUOnaI .. ..._..- ._ .. ,,.. ']ohnsain . ....'IA ... f rN& ldgn2 ITAe 1:'r. m lNuilrlmf 2dN 07/27/2012 696145 12 .,., .. 0l,/04/2.01:9 719855 YA ,.. Name: Adams, Adil Daoud DL/ID: 713YY6075 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. — Office of Driver Services Iowa Department of Transportation Name: Adams, Add Daoud DL/ID: 713YY6075 14rar.27' 201411:26AN� Div of Criminal Investigation ., —." ... .. e' # 1 p V g U V. 'Y 7STATE OF IOWA �� o e iii `�r r7A��r �i �i z1�Er,.r�;,n, Tot Iowa Division of Crijubial XmveaUgaflon Support Operations Bureau,rw 215 19. 14 strost Res t 6i66 ;0 Name ,tad . swa Rtww �°a°tawaivaai. lCl ...(.ea�d't a'Rrd4.' ........................................ ate of Bi ah �mYedng�d � _ .... __.. wgtlAa�� ft,�aef�a�aaf��aftt �YttRdGbaO,V`ad k� Rada vdeoaxgAble, Brom Cada ot'R'owwn, Cha yi R......n No. 6116 P. 1 iru, 'YJJ`f i. L DCI Account Number:l ......................_..._.............. (gtnmPvgloa'�RoD Prose..Ak qj ,Kq@ yo.2y ...... City Clork's Office 4l� 9, sahfflg!ces P_ Nauet Iovraa tr'hyD ICa ��Z�40 Phone: 319 356,504.1, ,Wpm 3mmw356,1497 — 'dil ateF.Y. nalaa V) A, 0 q..) '57 77 a S S2,11'° l F I avoNweR° Rq'oraa the auh aat et'tgtm w°e duv�Nw � complete a:s•gwwdgdnoR blitory raoou°a9 may not 692A Por emwu ,pnlmt� argnwsPadoR hPwtorp a eaadrtR lgdtaarsdaad@geada, �a ddRtowwre l to„� goWpr nR a waiver Release;IherahyglVaPenniraionfordwabovoyequaWngarfieinitoconductanYoulactimindhla(otyrecordohcokwlththoMIslanofaiminYl Iner6g4tion (DCI), Any cdathial hle(aty data conccming mo Ilmt Is malntalned bythe Mhuay be released as allowed bylaw, °adxayer �^•.,... •» ''*�. • m:�..,»w, .m„ •.µ,. w, .ww,w w,�wrau. n ww,m.uvpsawmw. .:u..w.aw�s iwxw.w.�a rQ1C GJJ'nO MOY) As ofa search of the provided name and date of bitch revealed: nj -9 ya q:I C t. No Towe, Crfinkal History Record f.bu d with l;DC1 loave tai s al:lN:iwlariq ocotd attached, MI a.: r N:9rjaawitlalnq, Peraived .... [,iim,�rR�m+„a:.r�25,,.dl2014 3;37PM No 5896