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Home My WebLink About15-216CITY OF IOWA CITY 410 East washtngton Street 101ra CI vra 5 2 240-182 6 (31 C356-50 (319) 356-5497 FAX �feprGo ` Authorization Number (Office Use Only) -e., o u1 � 1-i APPLICATION FOR TAXI I MOTORIZED PEDICAB VEHICLE DRWER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Ftfday.) Failtrree to compfete tare "repufred;;,inf99mad0n will result In denial of the nonllcatlon First T. Name(REQUIRED) 2. Mailing Address (REQUIRED) 3. Contact Information (REQUIRED) Email - 4. Priorexperience in transportation of passengers: �. gam. .. 5. Have you ever been _:p CQ Middle e2 o P„o, l Last of any misdemeanors and/or felonies in this State or elsewhere? /, Where under the influence of alcohol or drugs in the last five Type of Offense Who When 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 five years? . Type of offense Where When 9. Have y%ou ever applied to be an Iowa City taxi driver using a different name? If yes, please provide thd'game(s) ` n a.r DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATI:;CERT( IED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW-", You must apply for an individual Department of Criminal Investigation Report (form eviff" upon redu"'q. (OVER FOR REQUIRED SIGNATURE AND NOTARY) 0801014 �':9 7 I hereby certifry that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license numb 7{' -b , ;3,��.� ,a I understand that ff I falsely answer any ques5ons 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 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 YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERICS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. tbhbwbh}kkk}I!}N ihMhkllkbbbNFwhM hY\hh}hh4ii4ehh}f!}'AM[4*MhhiN d'NYiM bilibAliblklnMA3R4M}hRkhtb}hb19'YeXYMMRM..N16{,lhlh4Yh4YIri\h6,166MkA#IiiehFih STATE OF IOWA ) COUNTY OF JOHNSON /} } l f �y ibed and sworn to before me by C ht U�iCl� r amnC=k- On this day of ri v-"1 Notary Public in and for the State of Iowa 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 weffare of 0MICIePtS of the City of Iowa Crty (TBW 5, unapier z, umy coaei. r" Sig r 07pobcMlef or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. Signatur of City Clerk or designee to Taxi cab businesses are required to provide Driver Identification cards. Cards must be S %" (width) and 5 Y:" (height) and prominently displayed to all passengers. }byy,ky,{y,k},yr,.y,kkbMyAy�}k}}}}}ykky}hy!}!hh}4hhbh }RHi�Y�Fh4*iMtkh'R4tA},AHiM biakYNh}}hRHRFkthAMM'YtWYFOOY}Ik}hkhlkf}h MfY#Y<O!}llLihthNitMh Office Use Only Approved application DCI report State certified driving record Website update owkrrnxmwveencsnrP<es 1�.00¢ 09x2014 4 s`' Irma- DOT www ivl/adrt rev SMARTER SIh1PLER i CUSTOMER (I R15iE'�`�.w.,�,_,., Office of Driver Services PO Box 92041 Des Mdnes, iA 553%.-9704 i'�9tor4l:. xt:r24$$'f2418i1i}-X37-1A2'k 1F u: 5IS-239-IWI www'kiwackxt gev Certified Abstract of Driving Record Inquiry Date: 12/30/2014 DL/ID R: 769YY2955 (IA) customer *: 2349835 Name: Hamrick, Chadwick Clam; D ID Status: None Aaron Address: 2510 INDIGO DR Audit 0: 7661903 DL Statusi VAL Issue Data: 01/02/2014 CDL Statue None Clty/State: IOWA CRY, IA Expiration 04/11/2022 CDL Cart None 522406808 Date: Status: Endorsements: 3 CDL Med None Status. Mailing Address: 2518 INDIGO DR Restrictions: NONE Restriction None Date of alrths 4/11/1977 Supplement: Mailing City/State: IOWA CITY, JA Sax; M 522406808 History Information ACCldentr - Accident Involvement Indicated does NOT mean the individual was at fault or given a citation. Date 08/20/2014 Name: Hamrick, Chadwick Aaron DL/1D! 769YY295S C-saa ftumbm IUi1 '.802293 IA _..,...,_._...._ Pursuant to Iowa Code 9321.10, I, Kim Snook, Director of Office of Driver Servkm, 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 saki 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: :WtIF �'•' IOWA�`�¢ D. 0. Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 12/30/2014 - .. Office of Driver Services Iowa Department of Transportation DDec.J.. 20It 1v9�27ftM to.r Div of Crim nal Investigation City 410111 V t VI IU114 b I STATH OF IOWA Criminal Hiatory Record Check-- Requesi Form To: loivn IHvlalm of Celmtdal151veatlgntlou Support opernlloao borenn,1"Flool' a15 R.11 i 81reot DOS Melnea, Ydlyn $0319 (516) 71S -H66 (115) 725-6900 Fax Y _ ...I.. .. Y-1. PW 1. .d T161Ar.1 b • ,IT (`6n..L n - NNo. 8015 JIOUP P. V2If I Doi AcutimtNumber: - [Itapol Ca Io From CITY Or K WA MY CITY CL RT118 OFBICE 4101t. WA !jWGTO1q5TR1tY r IOWA CITY IOWA. 51240 Ybonel 319-396-SO41 nax: 319-956-5447 Lf{dGi�alsxa ISIItd 11'at R1Ii0 =QtMMw11044 Ddto Myth tourwaw Gloxulor naanduor� _._ Social Sccutf Number ecamemldad 96 S? 3� Watvsr'rylfbli)yrrliolY: R9ffiontnriened[vnlvm hmntlteaa17rjecfofthotroryl[esf,ncomptetoralotiantAlatotYtceordlnnp nat ba relcasnblo, per Code ollown, Cllnpler 69x.2. For cmnnletn criminal h!s[ory recerd Information, na allowed hylgly, nlNrlya to fil n ]vniver alsnnlulrofrom the eub]ect of rile eegnesk Wrrtvat'�OIdf186:taersbydlYnpenntulonRrthe0ya db mI al�nodu6etmrwyro�oraebec�wbnlhoDtvrstonoreYlminel ynrosltgWim(800,.Aay ulilwl Wuryddc canscn16 a n I tray bot.Gawd slid Wv. l�irive: Slgnnnnaa_ owu Cdlninal ]�xstol v S�ecord Chg& 1tesulk we e�ty) As o£-3 I!I_. a 8C81oIL O1 fllD ))1'OVi(ICtC ll0 Al1Ct (IfttD DF WitA l eVoUlatll ' [� I�To Town Crlualnet I�ilstnly Itaa0i'd found wI111DCI aim '-7 TownC,61nal$istoxyRecord nttaolled,DCI# 5t7 r&7 O n I)5AWN6, - RerpirPA IIIn0."-�1PC-1O_J%II�AyIA�45A�"Ne, 94 Dec.31. 2014 9:27AM Div of Criminal Investigation No.8015 P. 2/2 IOWA CRIMINAL HISTORY DC1 00507646 FELONY CONVICTION PAGE 1 OF 1 DATE VRINTAD- DCIEODSO1646 2014/12/31 NAMRE HAM RI CR, COAD HAMRICT,CNADpICK AARON DOB SEX RAC MGT NOT EYE HAIR SKN POB 1977041/ M W $00 ids BRO BLK LOT IA ADDITIONAL IDENTIFIERS CCH RECORD +** 01 ARRESTED 199$0916 AGENCY: IA0020000 WASHINGTON CO $O CHARGE NO- 01 IA STATUTE TA908-7 HARASSMENT TRIC#E 022450902 COURT DISPOSITION AGENCY: IA0920151T WASHINGTON 00 DIST COURT COUNT NO- 02 IA STATUTE IA708-7 HARASSMENT CHARGE CLASH: MISDEMEANOR CONVICTION TRK##: 022450902 SENTENCE DISK MIFF DAT FINE *1DO 19961024 02 ARRESTED 19990902 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE XA713-6 ATTEMPT BURGLARY 2ND DEG TRH#: 037245001 COURT DYSPOSITION AGENCY: IA052015.7 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA713-6(2) ATTEMPT BURGLARY 21W DEG CHARGE CLASS: FELONY CONVICTION TRK#: 039241001 SENTENCE DISP EFF DAT .. COURT COSTS 19990226 -- PROBATION 2Y 19990226 ' SUSPENDED SY 19990226 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMXNAL INVESTIGATION, BUREAU OF IDENTIFICATION T3 A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. YN THE ABSENCE OF FINOBRPRINTS FOR POSITIVE IDRNTIFICATION 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