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Home My WebLink About17-009� r 1 CITY OF IOWA CITY 41 0 East Washington Street Iowa City, Iowa 52240-1826 (319)356-5040 (319)356-5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED) IDENTIFICATION NO. %-D(D q (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 C 3. Contact Information (REQUIRED) Email: t tl.-. M(,a116rMa11z4 (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) 0— 1:7— P-0(7 b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: 2!06)C;- zoog rzZILI Phone: 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 Plead Guilty Other Have you been arrested / charged with any traffic offenses in the last five years? /i/ L� Type of offense What happened to the charge? (Circle one) Where When 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? &C) C) Type of offense Where W helii,� 9. Have ypu�ever applied to be an Iowa City taxi driver using a different name? If yes, please,V de '[We name DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERP-f IED 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 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number O q � ss' 537 y issued on I /-%6-20 expiring on a % —17- 2UL . 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 proyjsions of Title, Chggter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of ApplicaryL� k� Date 0/_ H.H,HHHH1f f 1fllHHH,.,.,mHf„HH,,,HHH,HHH!ll,fffmHHHH,l1fH,,,H,HH„H,HHHff„mHf lflffl4f 14f1lfffmH.Tf,ff,f STATE OF IOWA ) COUNTY OF JOHNSON ) S bscribed and sworn to before me by �cT r7 PS / Y I^� Gt [ ��” on this 1 / day of CLr �` � U , ''�,y KELLIE K. FRUEHLING o L Commission NumOer Y2/879 -c'. C ( . t!' My I¢ Nota Public in and fort tate of Iowa V' ++++! emmmHlff+faHlflfllf. ... xff,fff.f+fxf.mf femrf 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 C4 of Iowa City (Title 5, Chapter 2, City Code). 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. 5ign,qt1jre of City Clerk or designde Date 11M1H1!!lltl1ff11f1ffffl,l� IfflflfH,HHfffffflHHmHHllHlfmlfmHH!!11!11-liYlfl}ffifffffflYffff N C� Office Use Only +J J -� C7 Approved application DCI report =a z S State certified driving record =" `? Website update o r aerknnxiDRNSe GenwL9201"nwded.DOC 07/2016 Inquiry Date: Customer Name: Address: 10WA00T www.iowado ov SMARTER I SIMPLER I CUSTOMER DRIVEN 9 Office of Driver Services PO Box 9204 1 Des Moines, IA 50306-9204 Phone: 515-244-91241800-532-11211 Fax: 515-239-1837 www.iowadol.9Dv Certified Abstract of Driving Record 1/3/2017 DL/ID #: 043SS5374 (IA) CDL Permit Class: None 1639571 Class: D Arthur, James Joseph Audit #: 6476952 527 MEADOW ST Issue Date: 11/16/2012 City/State: IOWA CITY, IA 522455019 Mailing 527 MEADOW ST Address: Mailing IOWA CITY, IA City/State: 522455019 Date of 11/17/1950 Birth: Sex: M Expiration 11/17/2017 Date: Endorsements: 3 Restrictions: Corrective Lenses Restriction None Supplement: History Information CLEAR DRIVING RECORD Name: Arthur, James Joseph DL/ID: 043SS5374 CDL Permit Issue None Date: CDL Permit None Expiration Date: None CDL Permit None Endorsemerts: o CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: None CDL Permit ELG Status: o CDL Cert Status: None CDL Med Status: None Pursuant to Iowa Code §321.10, I, Melissa Spiegel, 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 witnoss whereof, I have caused my clgneture and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: IOWA D. 0.1 Name: Arthur, James Joseph DL/ID: O43SS5374 1/3/20,r177 LI Office of Driver Services o Iowa Department of Transportatlorj-D m =^ bn 0 a- 0 State of Iowa Division of Criminal Investigation 215 E. 711 Street Des Moines, Iowa 50319 Phone: 515/725-6066 Fax: 515/725-6080 Iowa Criminal History Record Check Walk -In Rannact Your name: . a Address: -% Ale Ci /State/Zi :C Z j Phone #: -31 - a Requesting an Iowa criminal history record check on: Fill in all shaded areas. Last Name Apel ido (mandatory) First Name Primer Nombre (mandatory) Middle Name Segundo Nombre (recommended) �KFHU1� C -FAA s Td sE yph' Date of Birth Fecha,Nacimiewo (mandatory) Gender Genero (mandatory) Social Security Number (mcommwded) l g 5 O Male El Female L f -5 -P 6_ -70 f Wa' er SignatU Fi (If th request is on yourself, please sign. If the request is nn someone else, write N/A.) .w Results W1 USE ONLY As of �,\ 1110 , a name and date of birth check revealed: ❑ No record found Record attached DCI # w DCI initialsL Y; Lo Receipt Number of requests x $15.00 per last name = Total amount $ $, O O Method of payment:_ cash money order check # MasterCard or Visa Cardholder's name DCI initials Credit Card # DCI -83 (09/09/ 10; Revised 10/ 1 / 10; form reviewed 08/11/ 14) Exp. Date (Last 4 digits) N G �+ .w 1 � �2 .y ADDITIONAL IDENTIFIERS CCH RECORD *** O1 ARRESTED 19951014 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION SCHEDULE I TRK#: 007761701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: POSSESSION SCHEDULE I / MARIJUANA TRK#: 007761701 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19960208 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. DIVISION OF CRIMINAL INVESTIGATION IOWA CRIMINAL HISTORY DCI 00192705 " COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED - 2016/12/23 DCI:00192705 NAME: ARTHUR, JAMES JOSEPH 0 DOB SEX RAC HGT WGT EYE HAIR SKN POB 19501117 M W 511 190 HAZ BRO MED DC ADDITIONAL IDENTIFIERS CCH RECORD *** O1 ARRESTED 19951014 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION SCHEDULE I TRK#: 007761701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: POSSESSION SCHEDULE I / MARIJUANA TRK#: 007761701 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19960208 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. DIVISION OF CRIMINAL INVESTIGATION .� 0