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Home My WebLink About17-0441 l � 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. 1 % - (DAY (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 First S ilt n S, SA 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date (REQUIRED) written communication sent via email) o Lt- - / 2 - Z<, / b. Taxicab Business Name (REQUIRED) c�6 Cv. a T1 Cell Phone: Z -c -7-!4 1 S 13'-d 5. Prior experience in transportation of passengers:. 10 w-4 Y\ -4 X t r 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? ✓V O 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? '4:-'g Y Q S Type of offense Where When i(-0 y"\ 4ij'ir /y'�I �rSo -I II ' Whhatat happened to the charge? (Circle one) n o hnso n T_ W 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? Nei Type of offense Where When 9. Have you ever applie to be an Iowa City taxi driver using a different name? If yes, please provide ttie-name(s) L 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 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 hereby egfy h hate issued to me by the Iowa Department of Transportation a valid Driver's license number b 1 �� issued on a3_ -L6- f 3expirinq on o Lr -(2 . 1 �. 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 City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date --2- - 1 STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by A 5 S u 4 5 • t `a\<,QW r on this Z day of zn) i ,e• s. VVENDY S. MAYER ,%d=; 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). T/2//2? Date U ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO STIED BELOW. Office Use Only Approved application DCI report State certified driving record Website update 312117 Date Clerk/rA%IORN94DGEAPPL92014amended.DOC 0712016 /CA0rn1J 10 WA 0 0 T SMARTER I SIMPLER I CUSTOMER DRIVEN vvww•I°wadotgov Inquiry 3/21/2017 Date: Customer #: 6063944 Name: Makawi, Asaad Suliman Address: 2355 JESSUP CIR Office of Driver Services PO Box 9204 1 Des Moines, IA 50306-9204 Phone: 515-244-9124 1800532-1121 1 Fax: 515-239-1837 www.iowadot.gov Certified Abstract of Driving Record DL/ID #: 669A]7600(IA) CDL Permit Class: None Class: D Audit #: 6807976 Issue Date: 03/26/2013 History Information Convictions CDL Permit Issue None Date: CDL Permit Expiration 04/12/2018 Explanation Date: None City/State: IOWA CITY, IA 522461715 Endorsements: 3 Mailing 2355 JESSUP CIR Restrictions: NONE Address: Restriction None Mailing IOWA CITY, IA 522461715 Supplement: None City/State: ELG S92 Date of 4/12/1963 IA Birth: Sex: M History Information Convictions CDL Permit Issue None Date: CDL Permit None Expiration Date: Explanation CDL Permit None Endorsements: 103/12/2014 CDL Permit None Restrictions: IA ID Status: None DL Status: VAL CDL Status: None CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: None :itation Date Conviction Date ACD Explanation County JUR 0/27/2013 103/12/2014 1114 Fail to Obey Traffic Sign/Signal Johnson IA .2/21/2013 iOl/21/2014 M14 Fail to Obey Traffic Sign/Signal .Johnson IA 12/27/2016 03/23/2016 S92 Speed Johnson IA Name: Makawi, Asaad Suliman DL/ID: 669AJ7600 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: .e� #•'W.Nr`1j11 y` �4 �' IOWA '�� 3/21/2017 `-'- 4: .A ,i 1 Of Ofifvll -�' Office of Driver Services Iowa Department of Transportation .,. . Mar. 14. 2017 9;41AM Div of Criminal Investigation No, 5650 P. 1 F=,;m:Clry of Iowa City Ciera Office 310 3666x07 03/08/2017 17:62 as EO P.002/002 STATE OF IOWA Criminal History )record Check Request Form llCI Account 7Vumher: �ODZ-r (if applicable) To: lova Division of Criminal Investigation From City of lows City Support Operations Bureau, I" Floor City Clerk's Of oo 215 E. 7" Street _410 E. washhtaton Street _ Des Moines, Iowa 50319 i f5,yS) 724-6066 (515) 725-6080 Fax — — Phone: 319-356-SD41 Fax: 319-356-5497 1 am repucstino an lrnva Criminal )iiMnry flecord Check nnr LAst Name (mandamQ) First Name (manda(oly) Middle Name (fteonmended) 4.: I`' 1 Date of Birth (mandato) Cyender (mandalpgq Social security Number (r000mmended , Male ®Female Waiver Information: Without a signed waiver from the subject of the request, a complete criminal history record Wray nol be releasable, per Code of Iowa, Chapter 692.2. For complete criminal history record information, as allowed bylaw, always obtain a waiver signature from the subject of the request Waiver Release; l hoeby give pumission for dm above rcqutsting official to conduct an Iowa criminal history record check aid, 111MArion ofCiimioal Invcatigalion (DCO. Aly criminal hisloty dolt conuming me nut is maintained by the DCI Amy be rcicued m allowed bylaw �Iowa Criminal History Record Check Results (Ut:)ul -only) As of .1 \\ lV►-t1 -,a search of the provided name and date of birth revealed: No lowa Criminal History Record found with ACI ® Iowa Criminal History Record attached, DCl t! DClinitials / DCI -77 (08/25/10) D....I,..A TIm. a1,r 0 91117 6.91Dt1 N� F17d