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Home My WebLink About15-130P iq CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1 2, 191 IDENTIFICATION NO._/,�j (Office Use Only) APPLICATION FOR TAXICAB l 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. Name (REQUIRED) 5 L a L 0" IS Address (REQUIRED) Contact Information (REQUIRED) Email: s (All written communicate sent is email) 4a. Chauffeur's License expiration date (REQUIRED) / r 1-0 b. Taxicab Business Name (REQUIRED) /. 5. Prior experience in transportation of passengers: 4 /Z S ast tLP-, % ! sib-s,3C)-�,��1 I'/o roc Q h �`+g—a3L4e7 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? e s Type of offense Where When % N -Lo -X I L O 0 10 . A e-, "1,, 1 13 9�S What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended r11Plea Other 7. Have you been arrested / charged with any traffic offenses in the last five years? �:j e s Type of offense Where When What happened to the charge? (Circle one) 'Gbi victe-d) Dismissed Deferred Suspended Plead Guilty Other 8 Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When Mr, 9 Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) O TA c,r,_r DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE TAED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE G"t IEW You must apply for an individual Department of Criminal Investigation Report (form availa�% upon req st). C's 73 0 (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTAR7.. N W 02/2015 v APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Deprtment of Transportation a alid hauffeur's license number 7 (Q 3 9 1 L issued on 5 �/ l } expiring on -t , S 7 (D 1 understand that if I falsely answer any que o 'n 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 application, and I further agree that, if authorization to be a taxicab driver 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 Date STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by <t+�lbs •- ` L• 5tc. lnl on this a� day of WENDYS. MAYER1 Notary Publickin and for the k*********k#k***kh**********R###kk**********RRR#*##k*************#*##*k*hk********k*4#### 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 :5/r512.e. /'. Signature ofoli e hief or designee G/2wt�57. 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. Suture of� fiClerk or designee' ate c� G Office Use Only - + ZE Approved application a DCI report ry State certified driving record Website update Dlertr AXIDRNBADGEAPPL52014emended.DDD 0312015 Frojun.[�. [ul7vc�ll� Ivl- �arkuiv of criminal investigation No. 1406 F. 4/5 •'-- - - ---- •-. 06/22l201r 08:2. ..131 .-.-5; Jun.23, Lula 3:l7rRii u i v o Griro nal Investigation No. 1406 P. 5/5 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:OC340221 NAME: STRIBLSY,STEVE LOU1S D08 SEX RAC HOT WGT EYE HAIR 1952051.5 M W 507 155 HAZ BRO ADDITIONAL IDENTIFIERS CCH RECORD +i• 01 ARRESTED 19851120 DCI 003402.31 PAGE 1 OF I DATE PRINTED - 2015/06/23 SKM POB MED IA AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#; L29294001 COURT DISPOSITION AGENCY: IA0520150 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; L29294UOI SENTENCE DISP EFF DAT PLEAD GUILTY 19851128 FINE $20 19851128 COURT COSTS $20 19851128 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED HY 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 DCI, IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY TRAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION CIfil 4010WADOT �wm,iovvadotgov Si14AFTER I `tl PLE:F I (US TO"OF V [+RISEN Office of Driver Services PO Box 8204 =, Des Maines_ IA 5+9306-9204 Phoi 5V5 1800-532-11211 Fax:5-15-2'39-9837 wmw.iowadot_gov Certified Abstract of Driving Record Inquiry Date: 6/26/2015 DL/ID #: 769YY3916 (IA) Customer #: 699878 Name: Stribley, Stephen Louis Class: D ID Status: None Address: 2028 9TH ST APT 2 Audit #: 5217755 DL Status: VAL Issue Date: 05/11/2011 CDL Status: None City/State: CORALVILLE, IA 522411525 Expiration Date: 05/15/2016 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 2028 9TH ST APT 2 Restrictions: Corrective Lenses Restriction None Date of Birth: 5/15/1952 Supplement: Mailing City/State: CORALVILLE, IA 522411525 Sex: M History Information Convictions Citation Date Conviction Date ACD Erptanatlon County JUN 09/11/2012 10/09/2012 S92 '.Speed Johnson IA 01/05/2015 02/08/2015 N63 :Driving Wrong Way on One Way Street Johnson 7A Name: Stribley, Stephen Louis DL/ID: 769YY3916 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: >.t•""•4'ey, N 6/26/2015 D. 0. T. !F B�$c_E Office of Driver Services �a.y et Iowa Department of Transportation Name: Stribley, Stephen Louis DL/ID: 769YY3916