HomeMy WebLinkAbout15-060i
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C91Y OF �OWA CITY
410 East Washington Street
Iowa City, Iowa 52240-1826
[3 19) 356-5040
(3 19) 356-5497 FAX
1. Name (II'oJl➢!i,fR0..➢UN EIB)
U'.:)Bq'r1 RCA°'RIIC)N I"No......•.'(o .a,Xe _ U w ) t
APPU...RCATIION FOR '11"AMCAB U (MOTORIZED 11I1:iDRCAB lflE11-NIIC"G.IEM IDRIVER
((Police IlDepairtmmerd review imunust Ibe made (between 3 a.m. to 3 Ip.m., IMonday. -- IFrrnday)
I a)(trire, to a??R` I ." � 6,V ` „t6rEl n, r✓auliguif rrE' llx�� /fpt�t124 ,oL�uubl°@
e�ruCulr�� oa c,r�r�„„r�rwcirvua.,wr�r�p, ire,
2.. Address U12 a2) @ 11 ) . ..d� Y,n uf . 114 a... 5-ias
3. Contact Information(Ilbll-QU11III'N"11,7D) Frruail:_d t �y,�g A ....... Cell Phone: j,.j
(All written communication sent via email)
Awa. Chauffeur's License expiration date (ll"'RI11EQ .dli,"'tl1=11)j�.....I.::.....,�.)....:..........(....R..d2...................... _........... _........................... ..... —.._................ ........ .................................................................................
.
b. Taxicab Business Name (II dllIiCq. I RI f ,,U „........C,) ... .. .. ....... _ u,,, Ca - ._..
.................................................................................................................... ....................._.............
S. Prior experience In transportation of Ipassengers: ....V.-. .... w.j�t.................v.�..eg �.(�"_.. � ........' ' '� �. � � ._)::....—�:...^.....fin_( (:'....
'0..............°?.........................5::4....4...Rg.......,!"`^,
6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? &[0
TVPe of offense Where
a1 «
Convicted Dismissed Deferred
Suspended Plead Guilty Other
7. Have you been arrested / charged with any traffic offenses in the oast Torre years?
Vigra: oU cg Where 'hDgMn
What happened to the charge? (Circle one)
...., .... ...., N 2 111. ..
DEPARTMENTOF CRIMINAIL. UNVESTUGATRON (DCII) IBBPORT'U•' AND STATE CIERTIIFIIED
RDR RVI IPNG RECORD MUST ACCOMPANY THIIS APPRLUCAUON IFOR POLICE CHIEF IRIFVEW
You imuast apply fair aim iiundividuuall Department of Criminal IlnvestUgatuon Report (form avalialbie upon request)..
(SIR..z OND (PAGE FOR Rf.:?. tUIIP'R -'D SIGNATURE.:, AND INOTARY)
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INOMMMAIN, pill",
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fronttimes with all of the provisi f Title 5, Chapter 2, of the City Code. (Needs to be signed in of a Notary
Signature of f
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STATE OF IOWA )
COUNTY CF J®HNS®N )
Subscribed and sworn to before me b �+ 1. u a z ". y
on this da of
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-Sirre'of� ,
Police Chief or designee
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AFTER AP PROV AN... IBY"'111.1111E CITY CI...ER K YOU ARE AA.ITI•IIt° RIZEIID "1"0 DIUVE A "I'MICAIS IN IOWA CITY FOR NO
IWORE TII°IIAN ONE YEAR I1::rR0M 111E: V°MIM ILIIS"II"EII:D 113 II...OW
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EFFECTIVE DAM WAI'''L IIPNA"II"CIS '111-IIE CII•IIAU11:: "I: UFVS LICII:..JNSE 11!!:XV4"n0N IF 11 ESS '111-IIAN A YEAR.
Q"nnatare of City Clerk or dessgnee
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Lice Use Only
Approved application
DCI report
UwkrrAXID IVBADGFAPP.M14.,.n&r f.onc 022016
Mar.10. 2015 11:22AM Div of Criminal Invest gat on
Mar 09 2015 05:03PM City of Iowa CRy 319.339-5393 page 2
No. 2100 P. 9
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STA1 EO1 1 (0) A
CHMID81 History Record Ciucci,
Request o rui n,
Tw kWo l; bbllon of CrI mInmA Nveadg;a0v a
gapporl opea'a¢leaa Ouraam, II°%dlorar
2.19 P 7h Street
1$ea molaaea, rOwa. 50319
(515) 725 4090
(595)'7054000 Aran
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Wd1V&'10f9rrNff1#Onl WithwitaaNpWwaivermrom thaxiAbJecaoftaere(JUM,mhistory guard maynot
PA rdeaaa@ole, par Cada of Iowa, Chapter 69&L For UnpleLe ar9cebW h1dory areord W broation, as Wowed by law, aluv0ys
P���p¢e°a"�iR��dp&gT��:p.l rtY glue B¢emnfYauupi FoY baa rsgcrasBimg eZRtci�%&^ue rorAwrA rem Bates crirm6oed gixNaYy am aheckt ayinN¢¢A�awMvxai%marEetdeutrusN
aMtlPYYAaOdN�a(u0 F�%edexerr �F d rr POR � a� fna: iA riiPothi&t® � �' n%peNBdAGe %S eBBbWePb iay Beiv. '
(Da We Of*
As of,. - a senrch oftbo provided nono and data of birth myeged
No Iota Critminal History Record foa w$.flt:l.)CII13 k
1lov a. Uiniinal I9.nafoxy Recard attached, DC[
.....................................................
DC1 ffiafrfials,,,,
DCI -77 (08/25/10)
Received Time Mar. Q. 7015 17!77PM Mn 7004
Inquiry Date:
i.;.,
gi
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Customer #:
5868048
Name:
Abdella, Alaaeddin
Class: D
ID Status:
None
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DL Statua:
VAL
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„nuw,.ww vim.... a��0.1141 rv..111vo1
Issue Date: 12/19/2013
CDL Status:
None
4DI118`a 61 Dfdvei SetYN.cbs
CORALVILLE, IA
Expiration 07/31/2016
CDL Cert
PO Box. IR204 1 De -s i4 of e, I.A 03w -I 4
522411291
IrNane- 515444AI241.4100-51" 4121 lFac 516 239-1-537
Status:
Inquiry Date:
3/12/2015
DL/ID #: 544AG7008 (IA)
Customer #:
5868048
Name:
Abdella, Alaaeddin
Class: D
ID Status:
None
Nasreddln Elzaki
Address::
950 23RD AVENUE PL
Audit #; 7626874
DL Statua:
VAL
APT 3
Issue Date: 12/19/2013
CDL Status:
None
City/State:
CORALVILLE, IA
Expiration 07/31/2016
CDL Cert
None
522411291
Date:
Status:
Endorsements: 3
CDL Ned
None
Status:
Mailing Addressn
950 23RD AVENUE PL
Restrictions: NONE
Restriction
None
APT 3
Date of Birth., 7/31/1976
Supplement:
Mailing City/Staten CORALVILLE, IA
Sox: M
522411291
History Information
Convictions
C:t'toon Dae
Coer i«.t:ea Date
ACD Er Wyk,„. ,f ion
Co xftvs 9D
0912°I/70Ji2.
01/2 N./Z071.§
02/Ib'/IEU13
ihi14 lail tG: 0Irom77rmPflai •:nlyll7/�:Iryl'7al
lohn�,us'r 1fA ;
Name: Abdella, Alaaeddin Nasreddln Elzaki DL/ID: 544AG7008
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:
UIA'V
i
Office of Driver
Iowa Department Transportation