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Home My WebLink About15-095AMP-us!1�®� CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319)356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) - 2. Address (REQUIRED) IDENTIFICATION NO. S—C)q b (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) Failure to complete the "required" information will result in denial of the application First ` Middle 501 411nf4 (a Sk I out n 3. Contact Information (REQUIRED) 4a. Chauffeur's License expiration date (REQUIRED) g b. Taxicab Business Name (REQUIRED) _ Y V \a v 5. Prior experience in transportation of passengers: _ 3 \i,5 bi jln Li, (/A,/(af Last i 44- Fciy4G �v V, o- " ) 51 t�It - (a t,-- Cell Phone: n comma6icadon sent via email) S- e5 k, s k C (-1 W\ o 0. 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? \ ir Type of offense Where When (J'd'i� -r-oO What happened to the charge? (Circle one) Convicted DismissedDeferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic o nses in the last five years? P Type of offense Where All Iav, When J-3-11 What happened to the charge? (Circle one)� DGuil ,I., tConvicted Dismissed Deferred Suspended eOther 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When cn 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please p 'vtt thN .D DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAT�TWD DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CSWF WVIEtlI You must apply for an individual Department of Criminal Investigation Report (form available upon request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 0212015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby� pperti that I have issued to me by the Iowa D partment of Transportation a valid Chauffeur's license number l3{ dot _ issued on 4-`1-13 expiring on 5- )S- lS . I understand that if I falsely answer any questions in this application, that this application may 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 applica 'on, and I further agree that, if authorization to be a taxicab driver is granted, to comply at all times with all of the provision of le hapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant �1::�c I Date STATE OF IOWA ) COUNTYOFJOHNSON ) Subscribed and sworn to before me by 1�1_). i r� c on this acRfL�, day of in and for the State of Iowa ***k******#********#**************************************************************k******#**********************k*#*******_ I**#£t************** I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of Chauffeur's license Si n ture of Polrcd C f or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. Signa ure of City Clerk or designee /— Date S cien✓rrxioan MDceAPPre2014amendedDoc 0312015 N Q x' r 70 Office Use Only r : Approved application M DCI report N State certified driving record y Website update s1 cien✓rrxioan MDceAPPre2014amendedDoc 0312015 Iowa Department of Transportation i 0 othi of crrvff Servlt:es (loll Ftae) Ka 532 1121 PO lox 9204, ties Moines, to 54301592174 515-244-y124 FAX 51!5-2391331 Certified Abstract of Driving Record Inquiry Date: 4/14/2015 DL/ID #: 434ZZ0188 (IA) Customer #: 2286220 Name: French, Joseph Class: D ID Status: None 592 Dean IA 09/04/2014 12/17/2014 592 Address: 1506 SPRUCE ST Audit #: 6849312 DL Status: VAL Issue Date: 04/09/2013 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 05/15/2018 CDL Cert Status: None 522406030 Endorsements: 3L CDL Med Status: None Mailing Address: 1506 SPRUCE ST Restrictions: NONE Restriction None Supplement: Date of Birth: 5/15/1979 Mailing IOWA CITY, IA Sex: M City/State: 522406030 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/23/2011 06/20/2011 S92 Seed Johnson IA 10/15/2013 11/20/2013 592 Seed Johnson IA 09/04/2014 12/17/2014 592 Speed Johnson IA Name: French, Joseph Dean DL/ID: 434ZZ0188 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: 4/14/2015 10WA.. 1 0' d 0 T.C4: fY f P k" &Ai Office of Driver Services Iowa Department of Transporation Name: French, Joseph Dean DL/ID: 434ZZ0188 Mar.21. 2015 2.26FM 0.3/20/2015 13:48 FAX Div of Criminal Inuastioation No. 3621 i DCI IOWA STATE OF IOWA Criminal History Record Check .; Request Form To: Iowa DWbloa of Crtmloal lovestlahflolL 13vpport Operatloae Dllreae, 14 Floor 215 & 70' Street DeeMolnee lows 603!9 (510) 715-6066 (SIS) 725.6060 Fax DCI Account Number. 4)g3 `FG (lfawleahle) From: VA► frla3 Tkx 1 tj 5}enc. % Qv- -0 w, a 5a�il (3(9) 338- 394 Fax;. 319 -3-5T-4;_1 Y. 4/9 004 43 1 ")- j l tll,l { noun .... ....... .......n.... ......... iaet Name med{m ..��..� �..__. _... First Name(ma* Middle Name ncommMdoe F -(Ab � �os� t� ��OLL'- Date of Birth m.auge Gender Social Securt a ma �5� ��' � I� Male ❑Female ��" QNpumb�rQ�om (0 ��U� WalverYnjornwilon. Without a rfpled walver from the subject of the roqumy a complete cd oleal hrteryrerord may oat be rtleaeable, per Code of Iowa, Chapter 692.1. For Mpltcriminal history record Ieformation, a• allowed by law, always obtalnawnlrerel NroMomtheeubeetotther WalverX016 aC:lluabysivepamiulonfrrdo r orneblmewquetMlow erlmbWliamry,eeadclack Willi daDtvblmofCriminal . InvaL*kn MCI). AM omni kimmy dWMerlarr dim 11 DCI my be wined{rdtmwd by law. Walver Signarure: _ .. (DCC ale only) As of tn) a search of the provided name and date of birth revealed: 13 No Iowa Criminal Mstory Record found with DCI Iowa Criminal History Record attached, DCI N 1 1 U DCS initials + u nr nn.r , .inu ,i nn,n Mar. 27. 2015 2,21°M D l v of Criminal lavesti,atlon ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT BACK TAT L CALF TAT R CALF TAT RF ARM TAT UL ARM 'PAT UR ARM CCH RECORD *"* 01 ARRESTED 20060025 - AGENCY: IA0520200 IOWA CITY PO CHARGE NO- 01 IA STATUTE IA124-401-1D PROHIBITED ACTS/INTENT/DELIVER/ MARIJUANA TRK#: 101950501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST CCURT COUNT NO- 01 IA STATUTE: IA124.410 CONTROLLED SUBSTANCE/DELIVER/ACCOMMODATION/MARIJUANA COURT CASE ID: 06521 FECR076942 CHARGE CLASS: NON CONVICTION TRK#! 101950501 SENTENCE VXSP EFF DAT DEFERRED JUDGEMENT 20061207 PROBATION 1M 20061207 DISCHARGED FROM 20090803 DEFERRED JUDGEMENT AN ARREST WITHOUT DISPOSITION I5 NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCT, IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY: !DIVISION OF CRIMINAL INVESTIGATION 9 No.3627 P. i/9 IOWA CRININAL HISTORY OCi 00703918 NON CONVICTION PAGE 1 OF 1 DATE PRINTED - 2015/03/27 DCI:00783910 NAME: PRRNCH,JOE FRRNCH,JOSEPH DEAN DOB SEX RAC HOT WGT EYE HAIR SKN POB 19790515 M W 600 23U BLU BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT BACK TAT L CALF TAT R CALF TAT RF ARM TAT UL ARM 'PAT UR ARM CCH RECORD *"* 01 ARRESTED 20060025 - AGENCY: IA0520200 IOWA CITY PO CHARGE NO- 01 IA STATUTE IA124-401-1D PROHIBITED ACTS/INTENT/DELIVER/ MARIJUANA TRK#: 101950501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST CCURT COUNT NO- 01 IA STATUTE: IA124.410 CONTROLLED SUBSTANCE/DELIVER/ACCOMMODATION/MARIJUANA COURT CASE ID: 06521 FECR076942 CHARGE CLASS: NON CONVICTION TRK#! 101950501 SENTENCE VXSP EFF DAT DEFERRED JUDGEMENT 20061207 PROBATION 1M 20061207 DISCHARGED FROM 20090803 DEFERRED JUDGEMENT AN ARREST WITHOUT DISPOSITION I5 NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCT, IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY: !DIVISION OF CRIMINAL INVESTIGATION 9 No.3627 P. i/9