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Home My WebLink About16-210CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. —7— (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 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) _C,�'] 5. Prior experience in transporjation of Cell Phone: 3/9 i!v^f4�;e 3i9-y3o-y��/ 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended lead Guil Other 7. Have you been arrested/ charged with any traffic offher sin the last -five yeay�so? Type of offense -p �/�/C`l en i - 3E7- W a en rc e )� t!� 'IM tra5 Convicted Dismissed Deferred Suspended lead Guil Other 8. 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 bean Iowa City taxi driver using a different name? If yes, please provide the 6pne(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE iCERTIFIEP DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an individual Department of Criminal Investigation Report (form available upgn)request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I herebv�ceryfjt fat I have issued to me by the Iowa ent of Transportat' a alid Driver's license number (i�h I(�J issued on expiring on �. I understand that ', I falsely answer any questions in this application, that this ap i tion may be denied. I a r e 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 �j,_ Date STATE OF IOWA ) COUNTY OF JOHNSON ) S bscribed and swom to before me by �c e�y r ou.i on this _�A S+ day of in and for the State of Iowa 1 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 Chi (sof Iowa City (Title 5, Chapter 2, City Code). t d e o river' �� license / Z 0 Z of Police Chief or designee D to 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. Lir 1t' - 4_�f s� Signbtme of City Clerk or designee Y/w /6 Date N d v� rn Office Use Only N Approved application DCI report State certified driving record ro cl Website update CleNT"DRIVBADGE PPL92014..ended.DOC 07/2016 t LV- 4V IV IV. v J n n I UIV VI V I I II 11 1 1 6 t 1 n v t s l 1 9 d t I o n JFro `-.:.,,r .., ,..w.. 111y C1.1k un,oe 319 3666,,, gill No, gJ20 r. vii 09/1,/2016 10:66 8673 P.002/002 CidmiSTATE OF IOWA na➢ History Recoil d Check E Request omM ' To: Iowa Division of Crinllnel Islvestigstion Support Operations Bureau, 1S, Floor 215 E. 7th street Des Moines, lows 50319 (515) 725-6066 (515)725-6090 Fax Marg,, late of Birt DCl Account Number: (t—Th ppliublCT— Frons: CiCv of1va City City Cleric's office 410 E. 6VashirIton Street Fovea City, IA 52240 �— Phone: 319-3563041 Fax: 319-356.5497 ��p3� Male ❑Female _ - Wafver rnforfnafion. Without a signed waiver from the subject of the request, a complete criminal history record may not be releasable, pn• Code Of Iowa, Chapter 692.2. Forcom ete criminal bistoly record Information as allowed by law, always oGtainawatversi aturefrom the SUN act offive re nest. Waiver Release: I bemby tivepemlissim for the abavo sequesling official to crosduet u, Joao oriminal history mcord check sills the Division of Criminal Invicetill'I(Dq), My criminal hislosy dal, contenting me shit is maintaiocd by lha DC1 MAY be rolcascil ns allowed by lesv. Waiver signature: Iowa Criminal I3(iistDr )ltecord Check Results `� MCllsce dsrJt ", As of 104 , a searc)l of tGe provided name and date of bitill revealed: v -' N `.' No Iowa Ctinlinal History Record found with DO rl low, Criminal History Record attached, DCl # i 4,1 DCl initials,, Iv DCI -77 (08/25/10) Received Time Sep, 14. 2016 10:38AM No.3883 -v,cv. Lv iv iv, vi ivi v 1 v u1 yr iin l llal 1nve5llgaLlOn f, t IOWA CRIMINAL HISTORY DCI 00299366 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2016/09/20 DCI:00299366 NAME: MORROW,BRET ALLEN DOB SEX RAC MGT WGT EYE HAIR SKN POB 19640403 M W 602 345 ORN RED MED IA ADDITIONAL IDENTIFIERS SC CHEST CCH RECORD *** 01 ARRESTED 19930115 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA708-I 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 OP CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO MON-LAW E14PORCEMFXT 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. DIVISION OF CRIMINAL INVESTIGATION NO. 4i26 F. 6/12 w 0 rn rrl "V > PJ r-` Page 1 of 2 C,JIOWADOT vvww.iowadotgov SMARTER 1 51MPLER I CUSTOMER DRIVEN Office of Driver Services PO Box 92041 Des Moines, IA 50306-9204 Phone: 515-244-9124 1800-532-11211 Fax: 515-239-1837 wvm.xmadot.gov Inquiry 9/21/2016 Date: Customer 3617557 Name: Morrow, Bret Allen Address: 916 20TH AVENUE PL APT 2 City/State: CORALVILLE, IA City/State: 522411423 Mailing 916 20TH AVENUE PL Address: APT 2 Mailing CORALVILLE, IA City/State: 522411423 Date of 4/3/1964 Hirth: Sex: M Convictions Certified Abstract of Driving Record DL/ID if: 075AA1630 (IA) CDL Permit Class: None Class: A Audit #: 8981567 Issue Date: 04/04/2015 Expiration 04/03/2020 Date: Endorsements: NPT CDL Permit Issue None Date: CDL Permit None Expiration Date: VAL CDL Permit None Endorsements: CDL Permit None Restrictions: ID Status: None Restrictions: Corrective Lenses, CDL DL Status: VAL Intrastate Only, No Class A Passenger Vehicle Restriction None CDL Status: VAL Supplement: CDL Permit ELG Status: CDL Cert Status: Excepted Intrastate History Information CDL Med Status: None :itation Date Conviction Date ACD Explanation County JUR Ll/08/2012 12/12/2012 'S92 Speed (10 mph & under in 35-55 mph zone) Linn 'IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR )4/26/2007 ',368947 IA )2/08/2011 1617539 IA co Name: Morrow, Bret Allen DL/ID: 075AA1630 7 1 Pursuant to Iowa Code §321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Department oftRanspo tation, 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 IGwip Depdrtrriknt 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: 9/21/2016 Name: Morrow, Bret Allen DL/ID: 07SAA1630 Page 2 of 2 >""•'�i''� `�1C`� 9/21/2016 IOWA 0. T. D'0 ' F ...... �°== office of Driver Services Iowa Department of Transportation