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Home My WebLink About16-096A I II 1�ttp rtw13�0tat 1� CITY OF IOWA ■■y CITY 410 Oast Washington Strett Iowa City, Iowa 52240- 1 826 356-5040 43 19) 356-5497 FAX 1. Name �,REQUIR,ED) IDENTIFICATION NO, (Office Use Only) /V✓M Ill I rt -Ni APPLICATION FOR TAXICAB f MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) Failure iofure cornolete thethe "required" information will result in denial of fhe applicn[ion 2. Address (REQUIRED) CI f'lU IOI�f' 1�`¢fett Last 3. Contact Information (REQUIRED) Email ll L- 4muJ c Cell Phone, '3l9 071 F� (All written communication sent via email) 4a. Chauffeur's License expiration date (REQUIRED) k I /' b. Taxicab Business Name (REQUIRED) li 10 fgl r' 5. Prior experience in transportation of passengers or wl? t o b 6. Have you ever been arrested I charged with any misdemeanors and/or felonies in this State or elsewhere? tr 3 Type of offense Where When C) c✓J- b14L!'— h 'rl'-""f'-r ULI M 3 r U i)ryYlr b✓r f fuYK biu�1� nail, e��+ H Ul 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? Type of offense Where When/ What happened to the charge? (Circle one) (Ell lted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five ye@is? Type of offense Where ;Alien <t 9 Have you ever applied to bean Iowa City taxi driver using a d fferent name? If yes, pleaseptpyie the nam e+i- rV ,A 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 1 have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number -7 gC475ti issued on 3/"/ II expiring on I understand that if I falsely answer any questions in this applica5'on, that this application may be denied. I agree that in making this application, consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examir.o 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 fY{ Date F**k*x*R}44*#a#x*k-txxx%Wk4Yx*'kexwxxxxi-*k#*##}*#i**f!*M*#kk#kk##*'A-kki#YA***H***xk+.##M*11#***##R4k%*'A-AWWW*4tit**Ak#*}kix*+41s**F#*RiYWwk"AWA A4,n*kkk# STATE OF IOWA ) COUNTY OF JOHNSON ) u scribed an sw rn to before me by lC,1f0/ct j t,- ; 01000% 0 rQ-0iUVVAD01 MAPT(} 151": L'':T I CUSTOMF PRI�t�' wmv iowadot gov Inquiry Date: 8/19/2015 Name: Trimbell, Nicholas Scott Address: 636 S DODGE ST APT 6 City/State: IOWA CITY, IA 522404836 Mailing Address: 636 5 DODGE ST APT 6 Mailing City/State: IOWA CITY, IA 522404836 Convictions Office of Driver Services PD Box 9-104 ! Des IMvines, IA 50300-9204 Phof-e_ 535.244-9124 180(153=-1121 I Fax 515-23g-1637 W'ww, 16W:3dd,gev Certified Abstract of Driving Record DL/ID #< 700YY9754 (IA) Customer #: 377160 Class: D ID Status: None Audit 1r: 5200022 DL Status: VAL Issue Date: 05/04/2011 CDL Status: None Explratlon Date: 07/13/2016 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Restrictions: NONE Restriction None Date of Birth: 7/13/1978 Supplement: Sex: M History Information Citation Date Conviction Date ACD Explanation county 3UR 05/09/20D3 01/05/2004 A20 ;Operating While Intoxicated 'Black Hawk '.IA 10/26/2012 12/11/2012 M14 .rail to Obey Traffic Sign/Signal Johnson :IA 02/2712015 '..03/23/2015 M14 fall to Obey Traffic Sign/Signal Johnson 'IA Name: Trimbell, Nicholas Scott DL/ID: 700YY9754 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 field 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 sea! of the Department to be set upon this document, at Ankeny, Iowa this date: h�tI.. g/�4 B/19/2015 IOWA `:��c •...... 'r4®f �YiY ;ra Office of nrlver Services Iowa Department or Transportation Name: Trimbell, Nicholas SWtL DL/ID: 700YY9754 ;ug, i;, LU 17 II:jjNVI 0 1 v 01 GrlttllraI invesrl,go[lon N u - 2 f I 7 Sill Fru M:G tp• of Iowa nhy a,,. cOthce 316 366An8Y CU/IU/201& OP me vld3 P.002/002 �f fi Erta[ Hisfoi-fir Recolyd f:hcgjt r - ��eylte�4�arm Iowa DIN'Wan of C:rimin9l In1'Ctligatiun `.3upForl013,, bona hurtmn. I'I Floor 215 G• 711• ,mmet Des Moines, Cow& 50319 (515)725-6066 1 wn rem ag Iowa Criminal liisiori' Record �h M hull on; 1)C;I Accntm[ Pdun;ber; 4 0 0� _r i'1'ata: Ci[ of 1aua Cait City Clnrh's Difiec -- 410 C, Wa57rlrg(oll l mve City, IA 52'.40 h han t: 319-156-5041 Fax: 119-35G•5497 Name Male ❑Female � �I `63,- � 3 _�5'c1 rva"er Lnforelmaffo)?, Without signed walver from lilt tubjecl ofthe request, a corn Pleb tr(minnl history record nla� nol be rel easAble, per Codt of lwva, Chailler 692.2. For Curnultle criminal hislo ry record information, as allowed by law, ahvays 6bIa in a waiver signature fram thn Qum,t nrm...,,,,.., Waiver Relfase: I IWceby {rve wwjjasim, for IAc ohovt YcgUM0140410101 to CC AWq ae lawn mmuml Ai Tory rctoid cl eck a•i1h jhc 1.livision ofCri,niuel Invrsti�alion (DCII• My,n,I,,al hislay doe wceMn• nu lhel is mai Uined by Ik DCI my�oc rcicamd-e^; a1owed by laky Ivirim Stpllafftre UW,07 T%r. As of _aTT/f% /��j — a starch of the provided name and date of binll revealed 0 No Iowa Criminal History Record Tound with DO tP10"n Crilllinal llistufy I{ecord attechcd, llC] N llCa Received Tirr.e Aug, 10. 2015 9,OOAM Ne. MA All i.11. 241h Ri13JAM C v a 6riniinaI lrive:ti¢at of IOWA CRIMINAL HISTORY DCI 00620515 FELONY CONVICTION PAGE 1 OF 3 DATE PRINTED- DCI:00620515 2015/DB/ll NAME: TRIZIBELL,NICHOLAS SCOTT DOB SEX RAC HST WGT EYE HAIR SKN POB 19780713 M k 509 170 PRO BRO FAR IA ADDITIONAL IDE14TIFIERS TAT BACK TAT R LEG TAT UL ARM CCH RECORD --x 01 ARRESTED 20000512 AGENCY: IA0070100 CEDAR FALLS PD CHARGE NO- 01 IA STATUTE IA123-47(1) PROVIDING ALCOHOL TO MINOR TRK#: 600115601 COURT DISPOSITION AGENCY: IA00701517 BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE; IAX23-47-1 PROVIDING ALCOHOL TO MINORS CHARGE CLASS; MISEEMEANOR CONVICTION TRK#: 600115601 SENTENCE FINE $250 PROBATION 1Y SUSPENDED GOD 02 ARRESTED 20020723 AGENCY: IAD070100 CEDAR FALLS PD CHARGE 170- 01 IA STATUTE IA124-401-5 P069 MARIJUANA TRK#: 600841401 CHARGE NO- 02 IA STATUTE IA714-2-4 THEFT 4TH TRK#: 600541402 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT 110- 01 IA STATUTE: IA124,414 POSSESSION OF DRUG PARAPHERNALIA COURT CASE ID •, 01071 SRCR107637 CHARGE: CLASS: MI$AENENN'OH CONVICTION TRN#: 6DO841401 RESTITUTION SENTENCE PINE $50 COVRT DISPOSITION AGENCY: IA007015J BLACK HAWK CO bTST COURT COUNT NO- 02 IA STATUTE: IA714.2(4) THEFT 4TH DEGREE - 1978 DISP EFF DAT 20000912 20000912 20000912 DI$P EFF DAT 20021018 No. 21L7 F, )/ I I Aut,.1 2U1� I , JCPM Civ 01 b minae IrVestigaIIca COURT CASE ID: 01071 SRCR10763'7 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 600041402 RESTITUTION SENTENCE SUSPENDED JAIL 30D FINE $2250 PROBATION 2Y 03 ARRESTED 20030509 AGENCY: IA0070000 CHARGE NO— 01 OWI 1S7 OFPRNSE TRK#: 601141201 COURT DISPOSITION AGENCY; IA007015J COUNT NO- 01 BLACK EAWK CO SD IA STATUTE IA321J-2 BLACK HAWK CO DIST COURT IA STATUTE: IA321J.2(A) OPER VEH NR INT (OWI) / IST OFF COURT CASE ID: 01071 OWCR114032 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 601141201 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION RESTITUTION SENTENCE TIME SERVED 5D SUSPENDED JAIL 1150 JAIL 120D FINE $1000 PROSATXON 2Y DCI 00620515 PAGE 2 OF 3 DISP EFF DAT 20021010 2DO21016 20021010 DISP EFF DAT 20040106 20040106 20040106 20040106 20040106 04 ARRESTED 20040724 AGENCY: IA0070100 CEDAR FALLS PD CHARGE NO- 01 IA STATUTE IA124.401(5)(M) POSSESSION OF MARIJUANA TRK#: 601629101 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO— 91 IA STATUTE: IA124.401(3)-2 POSSESSION CONTROLLED SUBSTANCE, MARIJUANA COURT CASE ID: 01071 SRCRI24512 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 601625101 LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EEF DAT I c L l l? r. ! U/' Aug, ii. 2u 1i 11 -,:AIV] U i V 0T 6r171na Ii: yr j I, g 1101 IN01z1z) IF 1121• r COMMUNITY CORRECTIONS SUSPENDED JAIL 60D FINE $250 PROBATION 2Y IMPOSED REVOKED TIME SERVED 60D COURT DISPOSITION AGENCY: IA007015,1 BLACK HAWK CO DIST COURT COUNT NO 01 IA STATUTE: IA714.215) THEFT STH DEGREE. — 1976 COURT CASE ID; 0107: SMCR124519 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; 601629102 SENTENCE FINE $50 05 ARRESTED 20060621 AGENCY: IA00703DO CHARGE NO— 01 BURGLARY 3RD DEORBE TRK#: 602417201 COURT DISPOSITION AGENCY: IA007015,I COUNT NO— 01 WATERLOO PD IA STATUTE IA713.6(A) SLACK HAWK CO DIST COURT IA STATUTE; IA713.6A(1) DCI 00620515 PAGE 3 OF 3 20050110 20050110 20050i10 20050i10 20061207 20061207 20070529 DISP EFF DAT 20050110 BURGLARY 3RD DEGREE COURT CASE ID- 01071 VECRI40351 CHARGE CLASS: FELONY CONVICTION TRY.#c 602417201 RESTITUTION SENTENCE DISP EFF DAT COMMUNITY CORRECTIONS 20061113 FINE $750 20061113 SUSPENDED FINE $750 20051113 SUSPENDED PRISON 5Y 26061113 PROBATION SY 20061113 PRISON 5Y 20061113 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 INFORNuIITION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION