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Home My WebLink About15-252CITY OF IOWA. CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) 1 IDENTIFICATION NO. /c5�-Z5-Z.._. (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 2. Address (REQUIRED) )r75M 6 3. Contact Information (REQUIRED) Email: X. to I t t_ K\q/ poo.ro,41 Cell Phone:4n) ��- l{'} �3 (All written communication sent via email) 4a. Chauffeur's License expiration date (REQUIRED) V7 -ll `f /2024 b. Taxicab Business Name (REQUIRED) Jy M� S T2JCi 5. Prior experience in transportation of passengers: S,'Ac � , alje_OkL r „f 7012— IDENTIFICATION iff2 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When .. IIu. I-1N1-11o� w uis �11aI yc, k�]I cm vi 1c) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where ENIT-.Ti what happened to the charge? (Circle one) Convicted 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? 0 Q Type of offense Where When M 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please pr_R�jde th arnet¢ej DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE--CERTIMED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF P&IEW You must apply for an individual Department of Criminal Investigation Report (form available upon request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 02,12015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 1 hereb Acy e ify that have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number c' A ssR'2� issued on&/ly/14 expiring on j6Z/lq/21/21 . I understand that if I falsely answer any questions in this application, that this applica ionion 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 Tiff 5, 91-009f 2, of the City Code. (Needs to be signed in front of a Notary Public) I MASK" 0-1o;`11i STATE OF IOWA ) COUNTYOFJOHNSON ) Subscribed and sworn to before me by Ji -1 n on this day of a- WENDY S- MAYE Rd2RI Notary Pubili and for the State aIowa My Commission F;xpires 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). / iration date of Chauff r' icense Signature of Police Chief or de ignee —Date l 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 re of City Clerk or designee D-cr, -sa Approved application DCI report State certified driving record Website update c, ClerkJJDRIVBADGE PPL92014a ded.1300 0312015 Office Use Only Approved application DCI report State certified driving record Website update c, ClerkJJDRIVBADGE PPL92014a ded.1300 0312015 Matthew Duff McFadden Criminal History 46 Continued 4111/14/1997 Charged as Burglary 2od. Convicted of Trespassing #2 11/30/1999 Possession of Schedule 1 Substance — Marijuana - Convicted #3 06/27/2000 Charged with Assault While Displaying a Dangerous Weapon C n i e o ssault w h Intent to Cause Pain or Injury glt-10/14/2015 Matthe uff McFadden w «-yr Q C G10WA00T SMARTER I SIMPLER I CUSTOMER DRIVEN V�t1tYW,ICiY1tr��fC?� (��'_ Inquiry Date: Customer Name: Address: Office of Driver Services PO Sox 5204 I Des Motnes, IA 5030613204 Phone: 595-244-9124 i&H)-5112-11211 Fax: 515-239-1837 vrww.lowadot.gov Certified Abstract of Driving Record 10/13/2015 DL/ID #: 960AA8821(IA) CDL Permit Class: None 1832136 Class: Mcfadden, Matthew Duff Audit #: 1000 CHURCH ST Issue Date: City/State: IOWA CITY, IA Convictions Expiration Date: 7792149 02/14/2014 02/14/2021 Endorsements: 3 Restrictions: NONE Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit 522456011 Mailing 1000 CHURCH ST Address: None Mailing IOWA CIT', IA City/State: 522456011 Date of 2/14/1977 Birth: EXP Sex: M Convictions Expiration Date: 7792149 02/14/2014 02/14/2021 Endorsements: 3 Restrictions: NONE Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit None Expiration Date: None CDL Permit None Endorsements: 10/30/2013 CDL Permit None Restrictions: IA ID Status: EXP DL Status: VAL CDL Status: None CDL Permit ELG Status: 10/30/2013 CDL Cert Status: None CDL Med Status: None Citation Date Conviction Date ACD Explanation County .IUR 10/21/2013 10/30/2013 'S92 Speed 'Johnson IA 03/29/2015 -06/03/015 S92 Speed :Johnson IA Name: Mcfadden, Matthew Duff DL/ID: 960AA8821 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 theIowaDepartment of Transportation to so certify. +,^, rj;? cn In witness whereof, I have caused my signature and the seal of the Department to be set upon Of %curRa t, at Mk?ny, Iowa this date: X ---7f --i eV4lUtif`4 C. tr�0®IOWA : 10/13/2015 s _ p g D. 0. T. J44 cl ti h e .k% ate% Office of Driver Services 1 3,0 ,29. 2019 k52PM Oy1f'.'-V 1V V,A r. 0 Div of Criminal Investigation No. 1283 P. 1/4 a DCI IMn LVvU STA'T'E OF IOWA yr ti; >>„"�� Criminal history Record Check , Request Form DCl Account Number: 4383 -F-a✓ (ifepplWek) Vroom, yVlpVcr5 T��i 116 5}6rc*a pr Tor Iowa plvbdoa pf crlmiosl ibvufltaduo - support operfitlore Bureau, 1" Floor 115E 70Streat bel Mode, f00% 60319 (315) 736.6066 (SiS)72.QM Fac Pbobm: ,( 314 ) 338 - Fail, .31-17 1 am requestInx an Iowa Ur IMI nwtu, Last Nll{pe �emn cw,u v„wn v . Firnt N rw u. Middle Noble rewrarc Date tBlrth rmrdeb Gender 9octal Securl Ntiwber Wallor lrl%rrrralloj7 Wllboot o piped waiver from the robJect ottba requert, it complete criminal awtorymore may oot be releaaabie, per Code of Iowa, Chapter 691,2, PorgiijbILM erimlesl bblory record informatloo, ae allowed by law, always 4jaloy waver a stare Mom the auh art 01(be Wtliver Rejease:I Aaebi d•• pamimioe ror do &Wn requdMt @plebe io OrW n tows alb WMjy ward dWA wpb oe Divaia of (Irveial InvMevrbe fbCq. Ag eanietl btderydwmnaeeLrl we dw Igo h ue VC1 ray h d cola>.a 41040d 6Y l.w. Waiver Slgrrature: _ . As of �� l a��S ,a search of the provided name and date of birth revealed: No Iowa Criminal History Record found wD PCI Iowa Criminal History Record attached, DCI #—f�� Q �0 1 DC11nitWs_—A:C . _.-.._.._--.�... �..... ....._ fleCelVed Time Se P. 26 2015 4 : 2 4 A M No. 8913 per W 01y) lt-0 S>P.29. 2015 1 : 5 3 P M Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00564967 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2015/09/29 DCI:00564967 NAME: DPLORISTO.SHADOW DLORISTO,SHADOW MCPADDBN,MATTHXW DUFF SHADOW,DILORISTO SHADOW,DLORISTO D013 SEX RAC HOT WGT EYE HAIR SKN POA 19770214 M W 601 175 HAZ BRO PAR CA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRBSTRD 19971114 AGENCY: IA0520400 IOWA CITY UNIV SEC PD CHARGE NO- 01 IA STATTJTE IA713-5-2 BURGLARS 2ND DEGREE TRK#: 01.6686601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA716-7 - TRESPASSING CHARGE CLASS: MISDEMEANOR CONVICTION IRK#: 018686601 SENTENCE JAIL 26D COURT COSTS 02 ARRESTED 19991130 AGENCY: IA0520200 IOWA CITY PO CHARGE NO- 01 IA STATUTE IA124-401 POSE SCH I - MARIJUANA TRK#: 047944901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE - SR CHARGE CLASSP MISDEMEANOR CONVICTION TRK91: 047944901 SENTENCE JAIL 40H FINE $250 COURT COSTS LIC REVKD 03 ARRBSTED 20000627 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 TA STATUTE IA700-2-3 ASSAULT WHILE DISPLAYING DANGEROUS WEAPON TRKI : 053311601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT DISP EPP DAT 19971219 19971219 DISP EPP DAT 20000530 20000530 20000530 No. 1283 P. 2/4 0 - p Sep. 29, 2015 1'53PM Div of Criminal Investigation DCT 00564967 PAGE 2 OF 2 COUNT NO- 01 TA STATUTE; IA708.1(1) INTSNr TO CAUSE PAIN OR INJURY COURT CASE XD: 06521 SMSM035548 CHARGE CLASS; MISDEMEANOR CONVICTION TRK4: 053311601 SENTENCE DI5P EFF AAT FINE $125 2000110'1 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, EUREAU 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 THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION At No.7283 P. 3/4 r� Q - C? r