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Home My WebLink About17-014I = i CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 5 2240-1 82 6 (319) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) IDENTIFICATION NO. 1'1 — DI LI (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 2. Address (REQUIRED) 4-Scj S a 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date b. Taxicab Business Name (REQU 5. Prior experience in transportatioi 6 d. written i sent Cell Phone: 'z:s(�-9�(Y5`}33 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense What happened to the charge? (Circle one) Where When Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested/ charged with any traffic offenses in the last five years? Y6S Type of offense Where When (2 What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended(Plead-Gu4 Other 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? T6S Type of offense Where I 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide th@game(S)`ry 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 upori request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby c rti that I have issued to me by the Iowa De artment of Transportion a valid Driver's license number 1�S i�U� issued on 1 Ib expiring on & 1q . 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 prov' 'ons of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date �, V STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by K r t„ �e j tlrfJo on this Jo day of - awu aAiw Ztv 7 `fT 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 City of Iowa City (Title 5, Chapter 2, City Code). Expir:n date o is license i 611 y Sign2lde f ice Chief or designee Dat 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. Si ature f City Cle k or designee \\3A �—A bat v----------------------------------------- ------------ ----------- n_ ....� ....,..... Office Use Only Approved application6� D DCI report -: State certified driving record w Website update cieWTAXIDarvenoceAAPPL92014a� ded.Doc 0712016 Iowa Department of Transportation (Juice of Driver Services (loll Free) 800-532 1111 .� PO Box 9204, Des Manes, IA 50306X9204 515 244 9124 FAIL: 515 239 1831 Certified Abstract of Driving Record Inquiry Date: 1/29/2017 DL/ID #: Name: Hope, Michael Glenn Class: Address: 459 S SCOTT BLVD Audit #: 10/07/2016 CDL Status: Issue Date: City/State: IOWA CITY, IA Expiration Date: 3 522455527 None Corrective Lenses Restriction Endorsements: Mailing Address: 459 S SCOTT BLVD Restrictions: 3/6/1968 05/29/2014 Date of Birth: Mailing IOWA CITY, IA Sex: City/State: 522455527 Non -Payment of Convictions 155AC4503 (IA) Customer #: 3239199 D ID Status: None 1350116 DL Status: VAL 10/07/2016 CDL Status: None 03/06/2019 CDL Cert Status: None 3 CDL Med Status: None Corrective Lenses Restriction None Fail to Obey Traffic Si n Si nal Supplement: IA 3/6/1968 05/29/2014 M Johnson IA History Information Citation Date Conviction Date ACD Explanation County JUR 06 17 2012 07/18/2012 S92 Seed Johnson IA 03/28/2013 05/12/2013 S92 Seed Johnson IA 12/15/2013 02/03/2014 M14 Fail to Obey Traffic Si n Si nal Johnson IA 05/03/2014 05/29/2014 Improper Registration Johnson IA 05/26/2016 06/26/2016 Non -Payment of Improper Registration Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. tccident Date Case Number JUR )3/17/2012 677633 IA )9/21/2015 879405 IA Sanctions 1 Type Effective End ACD Explanation Occurrence JUR JUR Suspended 09/04/2014 09/08/2014 D53 Non -Payment of IA IA Iowa Fine Suspended 10/05/2016 10/06/2016 D53 Non -Payment of IA IA Iowa Fine t Name: Hope, Michael Glenn DL/ID: 155AC4503 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 witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: 1/29/2017 Name: Hope, Michael Glenn DL/ID: 155AC4503 Office of Driver Services Iowa Department of Transporation a Jan. 24. 201/ 2:04PM Div of Criminal Investigation 01/23/2017 06:17Yellow Cab of Iowa Clty No, 2077 P. 1/8 (FA%)3193382708 P.002/002 STATE OF IOWA torte 1 '+'Criminal History Record Request Form MEN To: lows Division orCrlminol investigation Support Operations Bureau, 1".rloor 215 S. 7'" Streci Des Molnts, lows 50319 (51$) 725,6066 _ �5'lT7Z5.6080 Fax �— DCI Account Number; 9967•F (lhppllcAble) From: Yellow Cab of Iowa Clty P.O. Bax 428 Iowa City, LA. 52244 (319) 338-9777 Phones Fax: (319) 339-7302 I Ii6nISALLj G (enh Date of Brirthenendnory) Gender (ran ndAto ) 'Social•Securi Number reoommcndod Male I OFemale Waiver Information, Without a signed waiver from the subject of the request, a complete erlminal history, record may not be releasable, per Code of Town, Chapter 692.3. Por, omotate criminal history -record Informatlon, as allowed bylaw, always Walver Release: 1 henhy give permiseiod for the ebov& requesting o0lelal to conduct en IOWA Orion Inn] history record check with the Divifion Of Criminal Invwriptton (DCO. My criminal history date c"'I'nln&me ep/t Is m/lntelrled by O -e CCI may be re)eesed a allowed by low. Waiver Signature: (DCT ule only) As of 7 I % a search of the provided name and date of birth revealed; ❑ No Iowa Criminal History Record found with DCI Iowa Criminal History Record attached, DCI # \\ :3 DCI initials JOU J DC1-77 (080110) D ... ;— A i;m, I,� 11 In17 4.17eN hl„ 10�o I oan.[4. Zvi/ L:U4Pm Uiv of Criminal Investigation DCI:00494587 NAME' HOPE,MICHAEL GLENN DOB SEX RAC 19680306 M W ADDITIONAL IDENTIFIERS 01 ARRESTED 19950207 IOWA CRIMINAL HISTORY COURT DISPOSITION PENDING STATUS UNKNOWN DCT 00494587 PAGE 1 OF 1 DATE PRINTED - 2017/01/24 HGT WGT EYE HAIR SKN POB 602 320 BLU BRO PAR IA CCH RECORD *** AGENCY: IA0520100 CORALVILLE PD CHARGE NO- OI IA STATUTE IA124-401-3 POSSESSION SCHBDULE I -MARIJUANA TRK#: 014615801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA TRK#: 014615801 SENTENCE DISP EFP DAT DEFERRED JUDGEMENT 19950707 PROBATION lY 19950707 COMMUNITY SERVICE 100H 19950707 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 No. 2077 P. 2/8 ria 0 � gg 6 ,l X7 C'