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Home My WebLink About15-300,r CITY OF IOWA CITY 410 East Washington Street Iowa City, larva 52240-1826 (3 19) 356-5040 (3 191 356-5497 FAX 1 Name (REQUIRED) 2. Address (REQUIRED IDENTIFICATION NO. Y5-3oo (Office Use Only) APPLICATION FOR TAXICAB I 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 3. Contact Information (REQUIRED) Email: Cell Phone: 3,/ (All written communication sent via email) 4a. Chauffeur's License expiration date (REQUIRED) , Z b. Taxicab Business Name (REQUIRED) _ 41Q ab 5. Prior experience in transportation of passengers: 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State blit ilsev&rev Tvoe of offense Where Wher ' »4 1 X72 og-meq / 1 i 91 What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended(-PleadGull Other Have you been arrested /charged with any traffic offenses in the last five yearsv Type of offense Where What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty ther 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 you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW 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 hereby certify that I have sued to me by the Iowa Department of Transportation a Vali Chauffeur's license number U ?�f) (g issued on expiring on I understand that if I falsely answer any questions in this application, that this application may be denied. I greethat 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 t he City �de. (Needs to be signed in front of a Notary Public) e i Signature of Applicar�� Date STATE OF IOWA ) COUNTY OF JOHNSON ) Su ` cribed and worn to before me by l � )c 1' l` / 1 % F'i'(` i` on this 4^ `— day of KELUE K. TUTTLE N tary Public in and for the State of Iowa fli} Cyo,lhis�io) E�ires 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 I IQj L -2U _� I. I ` 121�0� Signature of Police C ief or designee 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. Signatui,e,qf City Clerk or designee 1a-/� /Datezz Office Use Only Approved application A= DCI report -' — State certified driving record --+'"= T 4` Website update .w v Clerk!(A%IDRIVBADGE PPL92014amended DOC 03/2015 ,nwi u i v o7 t,rIminai InVFSi�ga,flon � "y clerk vlrloo a19 3666469 No, 164h P 1/3 12 2016 10.26 6334 P.002/002 To: lows Division of Criminal fures(igatior, Support Operations Bureau, 0 Floor 215 C. 7'e Street Des Moines, Iowa 50319 (515) 725-6066 (515) 725-6000 Rate I am fequ estinz an First DCI Account Number:—( C�� - F _ (ifapplicablc) --- Froin: _City of fovea Cid City Cler1P5 Office 4I IL, Washington Strret lova City, fA 52240 Phone: 319-356.5041 Fax: 31.9-336-5497 0 Male ❑Female I 1/7 r 7"z G . 1'l"alvel'rnfoemalionl Without a signed waiver from the subject of tilt request, a complete crinllnel history record may no( be releasable, per Code of lows, Chapter 692.2. For to Oblaih a waiver shmaturehon the Suhierf nf16a rernlolete criminal histary record Information, as allowed bylaw, always ..e Waiver Release: I tenby give penuiSSina for ,It abaverelnu(InrtOfficial m con an [Glue InvtS'*fiDll(DCIJ. ary erlmipnl6islaq'Bale C9rIC<nnn=me��l�,Ja id/s mei ain D'us¢UCl nnCriminal hl510r)'record check a'ilh the DIVISInD of Criminal alloryed Dy lase. Waiver Signalm: Iowa Criminal History Record Che& Results [DCI use only) As of. ) �_-a search of the provided name and date of With revealed: ❑ No lows Criminal History Record found with DCI Iowa Criminal Aistory Record attached, DCI # W x DCI .initials DCI -77 (08/25/10) --—" - Received Time Dec. 1 2015 9:15AM No, 3067 Dec. /. Ll1h 9:4JAIVI Div of Grlrill neI Investigation DC1:0018912.8 NAME: MEIER,MARK ALAN MEIER,MARK ALLEN DOB SEX RAC 19540918 M W ADDITIONAL IDENTIFIERS GLASSES SC L KNEE SC R KNEE IOWA CRIMINAL HISTORY DCI 00189118 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2015/12/07 HGT WGT EYE HAIR SKN POB 511 200 BRO BRO MED IA CCH RECORD www 01 ARRESTED 19730306 AGENCY: IA0820200 DAVENPORT PD CHARGE NO- 01 DELIVER MARIJUANA TRK#: L07626701 COURT DISPOSITION AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(3) CONTROLLED SUBSTANCE / POSSESSION/MARIJUANA - 1993 CHARGE CLASS: MISDEMEANOR CONVICTION TRK}): L07926701 SENTENCE DISP EFF DAT SUSPENDED JAIL 6M 19731030 PROBATION 19731030 02 ARRESTED 19910507 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L07626501 COURT. DISPOSITION AGENCY: lA0S2015C JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L07626601 SENTENCE DISP EFF DAT JAIL 2D 19910627 FINE $500 19910627 CREDIT W/TIME SERVED 7H 19910627 03 ARRESTED 19951111 AGENCY: IA0520200 IOWA CITY pD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND OFFENSE TRK#: 022560101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT No1647 r. V Dec. 7. 2015 9:43AM Dlv of Criminal Investigation No, 2645 F. 3!3 Dcl 00169118 PAGE 2 OF 2 COUNT NO- 01 IA STATUTE: IA32lJ.2(S) OPER VEH WH INT (OWT) / 2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 022560101 SENTENCE DISP EFF DAT JAIL 7D 19960221 FINE $750 19960221 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 A8S8NCE OF FINGERPRINT'S FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED, WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS T'HE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION V VU DOT WWWAOwdidotov SMAETER I 114PLJ I CUSTOVEF LIRP4EN ..,., .-.- 1_- Office of Driver Services PO Be, 9204: Des Moines. IA 50306-9204 Ptone_ 515-244.9124 1 806-532-1124 1 F31.- 515-239-1837 wi Wle'wadot.gov Certified Abstract of Driving Record Inquiry Date: 12/3/2015 DL/ID #: 075AA0689 (IA) CDL Permit Class: None Customer,*; 1683236 Class: D CDL Permit Issue None `++x..." Iowa Department of Transportation Date: Name: Meier, Mark Allan Audit #: 8410628 CDL Permit None Expiration Date: Address: 1031 290TH ST Issue Date: 09/03/2014 CDL Permit None endorsements: Expiration Date: 09/18/2020 CDL Permit None Restrictions: City/State: ATALISSA, IA 527209641 Endorsements: 3 ID Status: None Mailing PO BOX 132 Restrictions: NONE OL Status: VAL Address: Restriction None CDL Status: None Mailing ATALISSA, IA 527200132 Supplement: CDL Permit Status: EEG City/State: Date of Birth: 9/18/1954 CDL Cert Status: None Sex: M CDL Med Status: None History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 10/07/2012 11/05/2012 S92 Speed Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 01/18/2009 500760 IA 03/12/2013 730061 IA 09/13/2014 816583 IA Name: Meier, Mark Allan DL/ID: 075AA0689 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: ;.•""" ..!W",t 12/3/2015 Iowa : ¢s D. 0. T. �V� � Office of Driver Services `++x..." Iowa Department of Transportation Name: Meier, Mark Allan DL/ID: 075AA0689