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HomeMy WebLinkAbout16-230� r CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED) IDENTIFICATION NO.a p (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) r'1' r 5. Prior experience in transportation of passengers: f ,&—.' S SE e `tom 't.,. i court nication sent via email) q- ( —2.S hnr✓Z N�'i UL✓1 t'ti gfowt Last e -v I e- %, Phone: C��T-. .L k -t ac fo 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Yef J C�5 Type of offense Where .When r <-_v e ra /Su What happened to the charg Circle one) y� Convicte DDismissed Deferred Suspended ead Guj�y,% Other - 7. Have you been arrested / charged with any traffic offenses in the last five years . eS_ ^� Type of offense I(/4� x°15 Where When V I/«t,« IVB Ir1StArtvtccrstrci tt/21/:2oi� ��ss '1'"k�y9 e� ti en✓ 0.jr What happened to the charge? (Circle one) Convicted 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? eS I e of offense I j Where -When (q?�- --•� r l oA- /p-t,7k-c,h� O� Cktld Sttmvf - Lv� Q� Le5S� J� y e `,^�.7 4I'�_r r -r "1-�rle 9. Have you ever applied to be an Iowa City taxi driver s g a different name? If yes, please provide the name( l C)l(Vt P t 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) 07/2016 0Uef 7-'P.tirs c(l �1 �S � c k, t�r►A- Goy v l � 4 t*cxls ©k 17 �' POSetfj'irJl�y Ofd R.s K� Sw}jtiw�c L '_ less 1 w4v� t j f* -4+ o -F- ro+ APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify thathave issued to me by the Iowa Department of Transportation a valid Driver's license number 4XV (4 issued on a1 -27-.,b expiring on-)- 0 � . I understand that if I falsely answer any questions in this application, that this application 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 'ty8ode. (Needs to be signed in front of a Notary Public) Signature of Applicant Date 0-(3 6 �J C� STATE OF IOWA COUNTY OF JOHNSON Subscribed and sworn to before me by �Lr� p _ �• i_�S(1? r v\ on this!, day of Lze�Czl�n r zoo. �y \ r, Igotary Public' and fo a State oflowa� I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no informatio which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City q�fowo City (Title, Chapter 2, City Code). Expiration daoriver's/ce�e Zr Signature of Po Chief a 31l b N ate 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. Signbkird of City Clerk or designee //1�3 4,-- Dafe Website update aeirrAXIDRiVBADceAPPu2014a W.DOC 07/2016 N f'7 Office Use Only •d`Uri Approved application_-'- DCI report ca State certified driving record cr r-, Website update aeirrAXIDRiVBADceAPPu2014a W.DOC 07/2016 Oct. 9. 2916 3:38YM U i v of Criminal Investigation No.4Gjc r. I/j PY�....r..Y .-. ... v., —." Clsar. ...,i nae mi,a +-+eae<er 10/aa/2016 16:62 0706 P.007/002 STATE OF IOWA aT l , 'History Rec,ali•p3 c[1es;:i( _ RegUeSt Fors 11 9Q Iowa I)Ivislun of Criminal Investigation Support Operations Bureau, III Floor 215 E. 7'4 Street Des Moines, Iowa 50319 (515)725.6066 (515) 925.6080 Fax I' I 9 DCI Account Number: qotaZ Gfa+psdam�) --" From: City of Iowa Cit _ City CIerFes O ccfpcCf4 410 E. Wasbin ton 5troet lows City A 62140 Phone; 319-356.5041 Far: 319-356-5497 e �M ❑Fetnafe I ��� be rel e� [RfOper Coe Without a signed Waiver frosty the It of the request, a complete erimpaat his, record tray no, obtain releasable, per Code a Iowa, Chapter 692.2. ror complete criminal history record hsformatlon, as allowed bylaw, always obtain a traiver si nafus'c l)•am the sub'ect of the request. Y/ttdvtt R : I hertbp give permission for she Invudgation (I)CI). Above requesting oNicial to conduel an lova wlmimsl history Word cheek with the Division of Crimaah (I)CI). My criminal hisloty data concerning stye ut Iieinlalned by the DCl,nay he released As elloWo4 by law. As of Waiversignattipe; --- •. o,rU unu: or oirth revealed: ❑ No Iowa Liminal History Record found with DCT ,tet 1016VA Criminal History Record attached, DCI #�U tJ g r DC1111itials V V C— DC1.77 (08/25/10) Received Time Oct. 3. 2016 4:35PM No -5303 (uCi Int only) t, l'i rd Cat UGI. Y. LU10 }:)orivi Viv of criminal 1nveS ll gallon INo.4030 r. U3 IOWA CRIMINAL HISTORY DCI 00750508 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2016/10/09 DCI:00750588 NAME: LESLEIN,KYLE LEWIS DOB SEX RAC 19840901 M W ADDITIONAL IDENTIFIERS TAT R CALF HGT WOT EYE HAIR 6KN 507 163 ORN RED CCH RECORD ... 01 ARRESTED 20050516 N AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA712-2 ARSON IST TRK#: 101533001 CHARGE NO- 02 TA STATUTE IA124-401 PCS I TRK#: 101533802 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- O1 IA STATUTE: IA712,4 ARSON 3RD DEGREE - 1978 COURT CASE ID; 06521 FECR072530 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101533801 RESTITUTION SENTENCE SUSPENDED JAIL 180D JAIL 180D FINE $500 PROBATION lY TIME SERVED 67D IMPOSED REVOKED COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 FECR072530 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101533802 SENTENCE JAIL 2D SUSPENDED FINE $250 FINE $250 02 ARRESTED 20051101 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- O1 IA STATUTE ' IA708.1 ASSAULT CADS INJURY TRK#: 101696401 POB IA DISP EPP DAT 20050722 20050722 20050722 20050722 20051230 20051230 20051230 DISP EFF DAT 20050722 20050722 20050722 N LJ � Ci E 3 —1 C`a u c t. 7. iv I D ):) 0 r IYl U I V U I b I I III I 11 A l t n v e 5 t I g a l I u n DCT 00750588 PAGE 2 OF 2 ". `f0J0 I. it i COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- O1 IA STATUTE: IA708.2(2) ASSAULT CAUSING BODILY INJURY -1978 COURT CASE ID: 06521 SRCR074183 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101696401 RESTITUTION SENTENCE DISP EPF DAT APPEAL DATE TIME SERVED ISO 20051116 JAIL 15D 20051116 20060601 FINE $250 20051116 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 INOUIRY. DIVISION OF CRIMINAL INVESTIGATION i rva 0 J ca` ---+ ul i ARTS CiowAooT SMARTER I SIMPLER 1 CUSTOMER DRIVEN WWW'IOWBCIOt 90V Inquiry 10/13/2016 Date: Customer 4932550 Name: Lesion, Kyle Lewis Address: 700 KNOLL ST SE City/State: CEDAR RAPIDS, IA Convictions Page 1 of 2 Office of Driver Services PO Box 9204 I Des Moines, IA 503069204 Phone: 515-244-9124 1800-532-1121 1 Fax: 515-239-1837 www.iowadotgov Certified Abstract of Driving Record DL/ID #: 553XX8914 (IA) CDL Permit Class: None Class: D Audit #: 1325766 Issue Date: 09/27/2016 Expiration 09/01/2025 Date: Endorsements: 3 Restrictions: Corrective Lenses Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit 524033139 Mailing 700 KNOLL ST SE Address: None Mailing CEDAR RAPIDS, IA City/State: 524033139 Date of 9/1/1984 Birth: VAL Sex: M Convictions Page 1 of 2 Office of Driver Services PO Box 9204 I Des Moines, IA 503069204 Phone: 515-244-9124 1800-532-1121 1 Fax: 515-239-1837 www.iowadotgov Certified Abstract of Driving Record DL/ID #: 553XX8914 (IA) CDL Permit Class: None Class: D Audit #: 1325766 Issue Date: 09/27/2016 Expiration 09/01/2025 Date: Endorsements: 3 Restrictions: Corrective Lenses Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit None Expiration Date: None CDL Permit None Endorsements: 11/29/2015 CDL Permit None Restrictions: IA ID Status: VAL DL Status: VAL CDL Status: None CDL Permit ELG Status: 11/29/2015 CDL Cert Status: None CDL Med Status: None Citation Date Conviction Date ACD Explanation County JUR 10/26/2015 11/29/2015 B64 No Insurance Card Johnson IA 10/26/2015 11/29/2015 B51 No Driver's License Johnson IA Sanctions Type Effective End ACD Explanation Occurrence J1.JR JUR Suspended 12/01/2014 12/28/2014 D51 Non -Payment of Child Support IA IA Suspended 03/04/2016 09/21/2016 D53 Non -Payment of Iowa Fine IA IA Suspended 03/07/2016 09/21/2016 D53 Non -Payment of Iowa Fine IA - IA Name: Leslein, Kyle Lewis DL/ID: 553XX8914 Pursuant to Iowa Code §321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Department of Tfsportation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a true andA curate 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: htti)://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 10/13/2016 "Sy " •:%p'�y 10/13/2016 IOWA ' ¢ys P//'�`�°'" 1 oezyp ...... Office of Driver Services �n Iowa Department of Transportation Name: Leslein, Kyle Lewis DL/ID: 553XX8914 Page 2 of 2 http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 10/13/2016