The URL can be used to link to this page

Home My WebLink About16-0011 r 1 CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. /6-00/ (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 First / Middle r' Last C � To.7 I J'rs/79r / G�C ins �ii- icxr • Ji 3. Contact Information (REQUIRED) Email: 4a. Chauffeur's License expiration date (R b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa —.-><- C— li! !! of /��, is n communication email) Cell Phone: 3 0 4 `�-I l ';7'190 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When r��t7 /'C� Sr<N1r4Jl�1G "liScL /r op cCGPvI�h What happened to the charge? (Circle one) __.. (�Convicted j Dismissed Deferred Suspende Plead Guil Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Tvpe of offense Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended�Plead Gu� Other - 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 73 Type of offense Where When 9. Have youX/ver 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 cetthat I have issued to me by the Iowa Departm nt of Transportation a vali ' Chauffeur's license number �( �� z issued on expiring on 9t i .� I understand that if I falsely answer any questions in this application, that this applica ion 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 apptic do at ryry, an fher agrees+ t, if authorization to be a taxicab driver is granted, to comply at all times with all of the provisions v.itrie C rapte the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant , ' Date STATE OF IOWA ) COUNTY OF JOHNSON ) ubscribed end sworn to before me by Cr 1a.-4 tt) i Cj<- � Lx rlr r ckon this J� s� day of 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 orwelfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of Chauffeur's license Zf11 1.21 IZZ,t+j Signature—of Po ce hief 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. Signeiture of City Clerk or designee` Office Use Only Approved application DCI report State certified driving record Website update Clerk TAXIDRIVBADGEAPPL92014amended.DOC 0312015 ate Clerk TAXIDRIVBADGEAPPL92014amended.DOC 0312015 Dec.30. 2015 10:28AM Div of Criminal Investigation Fra m:Glay of Iowa Clry Clark Ofrlca 319 3666497 STATE OF IOWACrimiRal ��•: it t'RecordRequest Form To: Iowa Division of Criminal Investigation Support Operations llbn-eau, I" Floor 215 L. 71e Slice( Des Maines, IoeYa 50319 (515) 725-6666 (515)725-6000 Fax I gill requesting an Iowa C/C ozr/ // — on: No, 4297 P, 1/2 12/29/2016 10164 #SEE P.0021002 DC7 Account Number: w (ifaPPliwble) From: Ci(�dtlowaCit City Mrk's office 41U1>. Wasbingion street Iowa City, IA 5x$QU Phone: _319-356-5041 Far: 319-356-5497 14?1c) 1317enlale I L v �) 96 WljfreY lfrformnfiolu '1Vithoul a signed waiver 0'om the subject of the request, a complete criminal history record may not be releasable, per Code of Iowa, Chapter 692.2, For comorete criminal history record information, as allowed by law, always 012114 a waiver, sienatuve from file tuhirrt "re,„ ---# 6I"4iVBrRelenSe:lhercbygivcpennissionforrheohavc 1i if locond neer' for IordcheckwirhsheDivisianofCriminal naealiaaliDn (Ocl). Any crindual hislory data canrerning m is ned b ay he rel sodas red bylaw. WWWI-Signlni I -A )0 0 . if _ Ll Iowa Criminal History Record, Check Results�� WC) use only) As of a search of the Provided name and date of birth revealed: _ No lovt'a Grinlinal History Record found With DQ IV, • �s r� �rl --' -1 IOWA Criminal Ili story Record attached, Del # � �� in� � �''• L oa- - vel injtials*A�__ DCI -77 (08/2.5/10) Received Time tier. -29- 9015 9-41AM No 4561 Dec. 30, 2015 10:28AM D l v of Criminal ]nvestigation No. 4297 F. 2/2 IOWA CRIMINAL HISTORY DCI 00507646 FELONY CONVICTION PACE I OF 1 DATE PRINTED- 10CI:00507646 2015/12/30 NAME: HAMRICK,CHAD AAMRICK,CHADWICK AARON DOB SEX RAC HOT WGT EYE HAIR SKN POE 19770411 M W 500 165 BRO ELK LOT IA ADDITIONAL IDENTIFIERS CCH RECORD +++ 01 ARRESTED 19950916 AGENCY: IA0920000 WASHINGTON CO $O CHARGE NO- 02 IA STATUTE IA706-7 HARASSMENT TRK#: 022450902 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 02 IA STATUTE: IA706-7 HARASSMENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; 022450902 SENTENCE DIE? EFF DAT FINE $100 19961024 02 ARRESTED 19900902 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA713-6 ATTEMPT BURGLARY 2ND DEG TRK#: 037241001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA713-6(2) ATTEMPT BURGLARY 2ND DEG CHARGE CLASS: FELONY CONVICTION TRK#: 037241001 SENTENCE DISP EFF DAT COURT COSTS 19990226 PROBATION 2Y 19990226 SUSPENDED 5Y 19990226 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. vD XVISIO14 OF CRIMINAL INVESTIGATION Page 1 of 2 -4 , ku:�� www iowadot;gov Sty ARTER f SIPAPI'T' ( CUSTOTTR Off -ice of Driver Services PO Box 9204: Des Moines, IA 50306-9204 Prions_ 515-244-9124 1500-532-1121 I Fax: 515-239-1837 www.iowadot.gov History Information Convictions Citation Date Conviction Date Certified Abstract of Driving Record Explanation Inquiry 12/29/2015 DL/ID #: 769YY2955 (IA) CDL Permit Class: None Date: IA Customer 2349835 Class: D CDL Permit Issue None #: Date: Name: Hamrick, Chadwick Audit if: 7661903 CDL Permit None Aaron Expiration Date: Address: 2518 INDIGO DR Issue Date: 01/02/2014 CDL Permit None Endorsements: Expiration 04/11/2022 CDL Permit None Date: Restrictions: City/State: IOWA CITY, IA Endorsements: 3 ID Status: None 522406808 Mailing 2518 INDIGO DR Restrictions: NONE DL Status: VAL Address: Restriction None CDL Status: None Mailing IOWA CM, IA Supplement: CDL Permit ELG City/State: 522406808 Status: Date of 4/11/1977 CDL Cert Status: None Birth: Sex: V CDL Med Status: None History Information Convictions Citation Date Conviction Date ACD Explanation County ]UR 01/05/2015 02/03/2015 M14 Fall to Obey Traffic Sign/Signal ]ohnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 06/07/2014 802293 IA 08/20/2014 813321 IA Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 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: 12/29/2015 12/29/2015 COKV-M 'VVWztA Office of Driver Services Iowa Department of Transportation Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 Page 2 of 2 12/29/2015