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HomeMy WebLinkAbout15-265CITY OF IOWA CITY 410 East Washington Strcet Iowa City, Iowa 52240-1826 (3 191 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) . 2. Address (REQUIRED) IDENTIFICATION NO. j moi' , (Office Use Only) APPLICATION FOR TAXICAB 1 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 C5 L4/.l C Ct rpt 3. Contact Information (REQUIRED) Email: YaIJat'C h XC-- [� �yta,°�Lpgell Phone: 31 —'�?32S�(3 (All written communication sent via email) 42. Chauffeur's License expiration date (REQUIRED) i 0z / 04 z 0/6 b. Taxicab Business Name (REQUIRED)_�Ie 0ty cab U c zOwa CIT U 5. Prior experience in transportation of passengers: %(7 Vr�.c2rrS rItQy�, Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? YC'.5 Type of offense ar, Where ,qIti,, When What happened to the charge? (Circle one) Convicte Dismissed Deferred Suspended Plead Guilty Other Have you been arrested / charged with any traffic offenses in the last five years? �y e $ Type of offense Where When If-l2zl zo1 What happened to the charge? (Circle one) Conv~ i~e 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? y �� T e of offense �a I/lrH fo f�Yhu -I I1 Where 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please e o When CA/2 Gide. the n-2 t7 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAT, ERTIi DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE 1Y11kF REUIEVlf You must apply for an individual Department of Criminal Investigation Report (form availabIW upon regia s1). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) _ 0212015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that XX have issued to me by the Iowa Departm nt of Transportation a valid Chauffeur's license number 2:13 X f sglissued on xpiring on 6 20 . I understand that if I falsely answer any questions in this application, that this ap [cath n 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 Cade. (Needs to be signed in front of a Notary Public) Signature of ApplicanIft, Date Qct201 6" STATE OF IOWA ) COUNTY OF JOHNSON Subscribed and sworn to before me by c K Mu t/tC a I on this � n — day ofr 4- 2c71.� 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). co/10i (� 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. Signature of City Clerk or designee Approved application DCI report State certified driving record Website update Date cr+ Office Use Only o Cn cierk(TAXIDRw6ADGE PPr92014ame1aea Doc 0312D15 Q41:0WA00T fA1WWiGVVa(l smi RiB ISlMP!-EP Ifllrin Lck DRIVEN ('tfice of ©rr4e€ Services P,D Bo+. 92t341 Des Maines, l.A. 9030D-9 &4 Phare: Els 244-91241800--532-1121 Par. 515-33r_123' wwvv.�rwadc't guy Inquiry Date: 10/27/2015 Customer #: 3382468 Name: Duncan, Scott Kendall Address: 1131 3RD AVE APT 28 Certified Abstract of Driving Record DL/ID #: 713YY5941(IA) Class: D Audit #: 6416454 Issue Date: 10/25/2012 Expiration Date: 10/10/2016 City/State: IOWA CITY, IA 5224D2013 Endorsements: 3 Mailing 1131 3RD AVE APT 2B Restrictions: Corrective Lenses Address: .06/05/2012 Restriction None Mailing IOWA CITY, IA 522402013 Supplement: City/State: None DL Status: Date of Birth: 10/10/1959 None Sex: M IOWA s', History Information Convictions COL Permit Class: None CDL Permit Issue None Date: CDL Permit None Expiration Date: ion CDL Permit None Endorsements: .06/05/2012 CDL Permit None Restrictions: IA ID Status: None DL Status: VAL CDL Status: None CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: None ri'_.7"t^c', D3`se 6+1.'wr cficn D -:e oCIDP!un':: ion County 311$. 04/22/2012 .06/05/2012 3592 Speed Poweshiek IA 11/01/2013 .03/25/2014 'M14 Fail to Obey Traffic Sign/Signal Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. r -cl:tc n' 1'++axn CrYe Number 1t A 03/3D/2015 852252 IA.......... Name: Duncan, Scott Kendall DL/ID: 713YY5941 Pursuant to Iowa Code §321 10, I, Kim Snook, Director of Office of Oriver 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 1 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, �Zga this date Name: Duncan, Scott Kendall DL/ID: 713YY5941 0114 ti®�:•® 10/27/2015 N ..... IOWA s', Co 'nF........... . .. pf`�= Office of Driver Services Iowa Department of Transportation .. Name: Duncan, Scott Kendall DL/ID: 713YY5941 0ct.2.1, 2015 12:32PM Div of Criminal Investigation No.9063 P. 2/2 IOWA CRTMINAL HISTORY DCI 00560308 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - DCI :00560308 2015/10/21 NAME: DUNCAN,SCOTT KENDALL DOB SEK RAC HGT WGT EYE HAIR SKN POB 19591010 M W 506 140 BLU BRO MED PA ADDITIONAL IDENTIPIERS CCH RECORD *** 01 ARRESTED 19970905 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401-5 POSSESSION/SCHEDULE I/MARIJUANA TRK#: 037269401 COURT DISPOSITION AGENCY: 1AD52015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124-40195) POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/ MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 037269401 SENTENCE DISP EFF DAT FINE $250 19971121 COURT COSTS 19971121 02 ARRESTED 19971007 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION/SCHEDULE X/MARIJUANA TRK#: 037285201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124-401 POSSESSION /CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA COURT CASE ID: 06521 SRCR045809 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 037285201 .SUBSTANCE ABUSE EVALUATION SENTENCE DISP EPF DAT JAIL IDD 19980226 FINE $250 19980226 r.n PROBATION lY 19950226 F+ Y° AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD,-'.''. CD_ MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION. BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW d ENFORCEMENT AGENCIES BY THE DCI.,` —O y IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD I9.'C., BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD'__ COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRXMINAL INVESTIGATION 0ct,2.12015 12:32PM Dlv of Criminal Investigation No, 9063 P. 1/2 10, rwzu to w:jo vei iow Cab or Iowa �ITy (FAX)31933P270a P. 002/002 Tot STATE OF IOWA Criminal History Record Check, Request 1♦orm lown Division of Criminal Investigation Support Operations Bureau, I" Floor 215 E. 7'° Street Des Ivlolnes, Iowa 50319 (515) 7256066 I am raauestina an Iowa Criminal Plctnry Rm,. M Chnn4 nm DC1 Account Number; `9967-F (ICapplioable) From., Yellow Cab oflowA C1tY P.O. Box 428 Iown City, L4, 52244 Phone• Fax: (319) 339-7302 Last Nasrte (mandalo Firat Name (mandatary), Middle Name ortaommaaaed) DL) L4 C al -I As of /D , a search of the provided mune and date of birth revc�lid: Date of Birth (imndalary) Gender (mandatory) Soeial Securl NuanharrocammmmoJondde^d) r! Q — 1 © ( [Kale ❑Female 5 ~ —5-9s 4 WaNdr Information. Without a signed waiver from the subject of the retitiost, a Complete griminat history record may not be releasable, per Code or low Chapier692.2. For comolote criminal history record information, as allowed by law, always obtain it waiver sijZnaturib from the sublett of the request. Waiver RaidaSet I hereby give petmlolon forlhc above raquorling otflclal to conduct an iewa crlminsl 114toy0100rd check with the Division of Criminal lhvmlgadon (DCO. Any criminat hlnory data codec ig me lha s n.lnod by the DCI may be released m allowed by low, Waiver Signal— DCI-77 (08125110) Received Timp Or.l. 16. 9016 9:46PM NIIn.091ni Iowa Criminal History Record Check Results 0 1 w only) As of /D , a search of the provided mune and date of birth revc�lid: ❑ No Iowa Criminal History Record found with DCI Iowa Criminal History Reoord attached, DCI # ��� _'i 0� `�'= •1 i DC1 initials— DCI-77 (08125110) Received Timp Or.l. 16. 9016 9:46PM NIIn.091ni