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Home My WebLink About15-230CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED 3. Contact Information (F IDENTIFICATION NO. IS (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 4a. Chauffeur's License expiration date (F b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of 6" Have'you ever been trrested /charged with any misdeme6nors and/or felonies in this State or elsewhere? What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended <Plead Guil Other Have you been arrested / charged with any traffic offenses in the last five years? \!per v Nrl'// 4 (Convicte� Dismissed Deferred &spended Plead G. ilt 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When N you ever applied to be an Iowa City taxi driver using a different name? If yes, please prOffT thEl ame(p�- DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAT04q-ERTIFMD DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE C iIEF RI&EW You must apply for an individual Department of Criminal Investigation Report (form available upon request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 02/2015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I herer)v cue at I have issued to me by the Iowa Dep m nt of Transportation v id Chauffeur's license number �r/ifi ssued on.expiring on C7 0 I understand that if I false -y a steer any questions in this application, that this ap ca on may be denied. I bgr& 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 atl0 - Date.*,2a4 STATE OF IOWA ) COUNTY OF JOHNSON ) S=and swom to before me by 15 Rt -e -f" ✓ z rrro u7 on this day of 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 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 Cde). Expiration date of Chauffeur's license 03 40zto �"� I Lq3 c'R221,�7 Signature of Mice thief or designee Date AFTERAPPROVAL 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. AZ44*� -e- �� Sigrikure, of City Clerk or designee 9 � Date/ rte aen,rrw IDRwenocrAPPr92014amended.00c 0312015 Office Use Only C- G Approved application e-�-�• ry :- DCI report State certified driving recordC;_a r n 171 Website update ; �, C(; ys IV r i aen,rrw IDRwenocrAPPr92014amended.00c 0312015 j';9'riU%NA DDT ww"N'lowacotgov 5RfiAlIYER (56M°LEP I CUSTO'v=iR C)R1tiE4. Office of Driver Services PG Box. 8204 ; Des Wipes. IA 5:0306-9204 Phorl 515-244-9124 1 80Gf 32-1121 J Fax. 515-2n-1837 www rnwadatgov Certified Abstract of Driving Record Inquiry Date: 9/18/2015 OL/ID #: 075AA3630(IA) Customer #: 3617557 Class: A Name: Morrow, Bret Allen Audit #: 8981567 Address: 916 20TH AVENUE PL APT 2 Issue Date: 04/04/2015 Johnson 1A... Expiration Data: 04/03/2020 City/State: CORALVILLE, IA 522411423 Endorsements: NPF Mailing Address: 916 20TH AVENUE PL APr 2 Restrictions: Corrective Lenses, CDL Intrastate p•�;'w� Only, No Class A Passenger Vehicle -10 Restriction None Mailing CORALVILLE, IA 522411423 Supplement: c city/state: Iowa Department of Transportation ` Date of Birth: 4/3/1964 Sex: M History Information Convictions CDL Permit Class: None CDL Permit Issue Data: None COL Permit Expiration None Date: CDL Permit Endorsements: None CDL Permit Restrictions: None ID Status: None DR. Status; VAL CDL Status: VAL CDL Permit Status: ELG CDL Cert Status: Excepted Intrastate CDL Med Status: None ;it'ation Date. Conviction Data RCP Explanetion County 3UR R/08/2011 03/08/2011 1101 Fail to Yield Hugh[ of Way Johnson IA 18/31/2012 _ .12/13/2012 F04 Seat Belt Violation Johnson 1A... .1/08/2012 12/12/2032 :592 Speed (10 mph &antler in 35-55 mph zone) .Linn 'IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Acue.nr Date Case Numher junk 04/26/2007 36B947 A 102/08/2011 .617539 IIA Name: Morrow, Bret Allen DL/ID: DJSAA1630 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: Name: Morrow, Bret Allen DL/ID: 075AA1530 N '01Ct®t,r f� �i I 1 .......,/6P, y IOWA asJ 9/18/2015 r c i . o ra• Y rNv D. 0.T'ws p•�;'w� -10 f•�R& sibv Office of Driver Services c Iowa Department of Transportation ` ra Name: Morrow, Bret Allen DL/ID: 075AA1530 State of Iowa Requesting an Iowa criminal history record check on: Fill in all shaded areas. Last Name 9peRzd,(manduiorv) First Name Prm,erMomhre(mandakxy) Middle Name SegmdoNombre(rccommcndcd) Date of Birth Fera,, N.,.-rmreato (mandatory) Gender venero Ini.dutnry) Social secori Number (recommendca) 0 j 03. J 9Z1 f 1lale El Female i�b7L�l_Cjn_�s tom^ Waiv/er Signature Firma(it the requestis rm xuursell; please sign Ir the request N on someone else write NUL) DC1 USE ONLY Results As of `j a name and date of birth check revealed: ❑ No record found EARecord attached DCI#�`�%T(�; E7� ca- y--.: co lr« „O cno DCI initials � zj,. o D co Receipt of requests ( x $15.00 per last name —Total amount S t5,60 01Number -a _ t'a-a " i t`J Method of payment: cash money order Wit,._._ check # = Master9IMor Visa (q 4dluis 1, Cardholder's name C7 DC1 initials ----------------------- 1--------------------------------------------------------------------------------------------------- --------------- Credit Card # Exp. Date DCT -83 (09/09/10; Revised 10/ 1/ 10; form reviewed 08/11/14) IOWA CRIMINAL HISTORY DCI 00299366 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2015/09/18 DCI:00299366 NAME: MORROW,BRET ALLEN DOB SEX RAC HOT WGT EYE HAIR SKN POB 19640403 M W 602 345 GRN RED MED IA ADDITIONAL IDENTIFIERS SC CHEST CCH RECORD *** 01 ARRESTED 19830115 AGENCY: IA0520100 CORALVILLE PD CHARGE NO— 01 IA STATUTE IA708-1 ASSAULT TRK#: L23192401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE: IA708-1 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L23192401 SENTENCE DISP EFF DAT JAIL 30D 19830413 COURT COSTS $9 19830413 AN ARREST WITHOUT DISPOSITION IS 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 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. fr' DIVISION OF CRIMINAL INVESTIGATION �f„• i�rtl RPh:.. •i7 y, p Li I— SeP.18. 2015 10:55AV Diu of Criminal Investigation No6260 P. 2 Fr., ^._�-�•y .,i owe .�i.r Cl erre �,.. ioc _,a ��bdx.y� 08/lam/2ols is;sa 9266 P.002i002 lam ,STATE' GF IOWA e, 11 Requem Form C-I-ilzlillaf HiStul-y Raced Check TO: Iowa t)ivisluo W Criminal hwesvigafiou Support Operatluns 81jreau, 1,, ph or 215 t. 71e Street Des h4uines, lawn 50319 0115) 725-6066 (515) 725.6080 ray oy--03-1 94q DC) Account 1lum6er; (iiapiilicable) Crum: ci[yrluwoC(� - City Clerh'a, pflicU 410 F. Wa_ sllfwi8feecl— -- lourya CIS, 1A 52240 — -_ Phone: 319-35G-5041 _ A P'az: 319-35-� wale QFewale n never a le, PirlRflDn; Without a signed waiver front (he subject of the request, a complete�'mine_ �1 �liffiory record may not he releasable, per -------- Code of ioq a, Chapter 692,2. !~or co)n�lefe criminal hislnry record inrormaf(;uit gs awpsed by 3a#,,, ahteys obtain a waiver si uelurc from the subject of the request.w IT'aiverRelense:lne,rnol e above ImesGgaliop(DCI), Ao.cFmby gine per dale Cpee nmgIs Thal is 11g official to cendutl an lows criminal hicloy rccO�R��}! Gisi rk MOU4 a al bislory tug me mainiaiucd 6y We 17'1 maybe released as allowed 6y viYrimiusl l3yrriperSrgnafttre: ��,,,n_., � '� � it -y° ,Eavtra �1-itlsirlai �is�f�r r �ecurd �f1ec� Results Iola n)e enl�yl As of _ - L_--- - a search of'the provided name and dale of bilih revealed; _- r, No Iowa C:rjfnin,':) History Record found with ICI - 1oc�n Criminal )ijstury Record a(lached, DO (! 1XI initials F F- 1" DCJ77 (0/25/10)u Received Time Sep, 16. 2015 4:45PM klo, 8166