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Home My WebLink About17-070Julie Voparil From: Roger Bradley <yellowcabic@gmail.com> Sent: Thursday, May 04, 2017 4:15 PM To: Julie Voparil Cc: David Stoddard Subject: request to remove driver Julie: Per our conversation today, Yellow Cab of Iowa City requests the removal from the list of drivers for us as follows: 17-068 Steven Warner Shrock exp. 1/17/2018 Thank you very much. Roger E. Bradley Manager Yellow Cab of Iowa City (319)541-0533 FAX 319-338-2708 vellowcabicn ianail.com www.yellowcabic.com ASG®IJ�' CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (3 19) 356-5497 FAX 1 oil 9 Name (REQUIRED) Address (REQUIRED Contact Information (REQUIRED) Email: Cell Phone: (All written communication sent via email) T�4 IDENTIFICATION NO. -7 —1) I:7_p _ (Office Use Only) 0 J r S APPLICATION FOR TAXICAB / MOTORIZED PEDICAE (Police Department review must be made between 8 a.m. to 7'" 4a. Driver's License expiration date (REQUIRED)w y 0i b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: F4 it / (7'. i Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of o7/ff}ennsse / l ,I /( WhereWhen ( 1-;) When Vf Y g7� —A X( 1.. -. A .e_i 1- 0 h A 1 G �7 _ c- I`1 61-i / ) )4 T '? /— What /— 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? Type of offense Where When C)C)S e)/6) ^/-- Y'�')ZA, Ie, A /9 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? L/O Type of offense Where When 9. Have you ever applied to be an Iowa CityAtaxidriver using a different name? If yes, please provide the name(s) 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 I hereby fy tha) I av I sued to me by the Iowa Department of Transport tion vall' Driver's license number jj t�1A issued on / expiring on - / I understand that if I falseily 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 gr ed, 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 Mary RI"c) es Signature of Applicant Date ' M21 �\ " nw C.)�, s 4 STATE OF IOWA ) v COUNTY OF JOHNSON ) Subscribed and sworn to before me by i(LD on this 3 day of 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). Expiration date of Driver's license 14% h.,>1 (-6 Y� Signature of Police Chief or designee 2513 1 Date 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. Sig City Clerk or designee Office Use Only Approved application DCI report State certified driving record Website update y13>tIq Date Gerk,TMIDRNBA GE WL92016am dw.DOC 07/2016 Lull y:IVHlvl� 2 or I,r lminai Investigation No. 1909 P, 3 + Gig?.."-'.+ _ •-^'-- 16rk-+.....- --, 04/24/2017 lO!l.. 961 ""' _--� �.v 02/002 STATE OF IOWA } Crilninai History Record Check Request Form 'ru: Iowa Division Or Criminal Investigation 5upporl Operations Bureau, 1" Floor 215 E. 7'h Street Des Moines, Iowa 50319 (515) 725-6066 (515) 725-6080 Fax if on: sfravC DLl Account Number: _7 DOS (ifapplicable) From: City of Iowa Cii City Clerk's Office 410 E. Washington Street Iowa City, IA $2240 Phone: 319-356-5041 Fax: 319.356-5497 me r % % 1. I ale Waiver 100r0tatiolr: Without a signed waiver from the subject of the request, a complete criminal history record may not be releasable, per Code of Iona, Chapter 692.2. For cornnlete criminal history record information, as allowed by law, always obtain a waiver signature from the subject of the rent,ocl_ I'i/aiVer Release: I hereby give persnirrion for she above requesting olhcisl to conduct on Iowa criminal hislorymcord check- gilh she Division o[Nminal invcrtigaliml (DCI), Any criminal history dela 1,Leonea(�ZU%3iing me 1113tt is maintained by the DCI may be clearcill as allowed by law, IyaiversiHnaAtre: W l j/ CA -IN n_ if As of , a search of the provided name and date of birth revealed: ❑ No Iowa Criminal History Reeord found with DCI Iowa Criminal HisloryRecord altached, DCI 4_M20 DCIinitials ioz - DCI.77 (08/25/10) --� Received Time Apr, 24. 2017 9:59AM No, 8948 IDCI use onlvl Q o, DLl Account Number: _7 DOS (ifapplicable) From: City of Iowa Cii City Clerk's Office 410 E. Washington Street Iowa City, IA $2240 Phone: 319-356-5041 Fax: 319.356-5497 me r % % 1. I ale Waiver 100r0tatiolr: Without a signed waiver from the subject of the request, a complete criminal history record may not be releasable, per Code of Iona, Chapter 692.2. For cornnlete criminal history record information, as allowed by law, always obtain a waiver signature from the subject of the rent,ocl_ I'i/aiVer Release: I hereby give persnirrion for she above requesting olhcisl to conduct on Iowa criminal hislorymcord check- gilh she Division o[Nminal invcrtigaliml (DCI), Any criminal history dela 1,Leonea(�ZU%3iing me 1113tt is maintained by the DCI may be clearcill as allowed by law, IyaiversiHnaAtre: W l j/ CA -IN n_ if As of , a search of the provided name and date of birth revealed: ❑ No Iowa Criminal History Reeord found with DCI Iowa Criminal HisloryRecord altached, DCI 4_M20 DCIinitials ioz - DCI.77 (08/25/10) --� Received Time Apr, 24. 2017 9:59AM No, 8948 IDCI use onlvl * , unpI. c U. cv is 2.Lvnni viv vi vi imi nai iuveILI gdLIUn 1011Y v7 L 4 IOWA CRIMINAL HISTORY DCI 00106530 FELONY CONVICTION PAGE 1 OF 2 DATE PRINTED- DCI%00186530 2017/04/26 NAME: SHROCK,STBVE 3HROCK,STSVBN WARNER DOB SRX RAC MGT WGT EYE HAIR SKN POB 19460111 M W 500 180 GAN BRO MEA IA ADDITIONAL IDENTIFIERS SC L CHK CCH RECORD *** 01 ARRBSTED/TAKEN INTO CUSTODY 19721124 AGENCY• IA0770000 POLK CO SO CHARGE NO- 01 DANGEROUS DRUGS/POSSESSION OF CONTROLLED SUBSTANCE TRK#: L07372601 COURT DISPOSITION AGENCY: IA077015J POLK CO DIST COURT COUNT NO- 01 IA STATUTE: DANGEROUS DRUGS/ POSBBSSION/CONTROLLED SUBBTANCR CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L07313601 SENTENCE PLEAD GUILTY JAIL 180D 02 ARRESTED/TAKEN INTO CUSTODY 19740430 AGENCY: IA0070300 WATERLOO PD CHARGE NO- 01 IA STATUTE IA204-401 DANGEROUS DRUGS/POSSESSION/CONTROLLED SUB/INTENT TO DELIVER TRK#: L07373701 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE: POSSESSION/CONTROLLED SUBSTANCE WITH INTENT TO DELIVER CHARGE CLASS: FELONY CONVICTION TRK#: L07373701 SENTENCE DISP EFF DAT SUSPENDED PRISON 5Y 19751025 PROBATION 19751025 03 ARRESTED/TAKEN INTO CUSTODY 19900722 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA236-12-2 ASSAULT/CAUSING INJURY/ DOMESTIC ABUSE TRK#: L07373001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA236-12-2 ASSAULT CAUSING INJURY CHARGE CLASS: MISDEMEANOR CONVICTION ruvU. cUir 7:IniYi u i v of oriminai investigation No. 1909 DCI 00166530 PAGE 2 OF 2 �r TRK#: L07373801 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT PROBATION lY 19901212 SUSPENDED 30D 19901212 BATTERER'S EDV PROG 19901212 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 C 1®SIVA DOT www iowadotgov Inquiry Date: Customer Name: SMARTER 1 51MPLER I CUSTOMER DRIVEN Office of Driver Services PO Box 9204 1 Des Moines, IA 50306-9204 Phone. 515-244-9124 1800-532-1121 1 Fax: 515-239-1837 sw�yw.iowadot gov Certified Abstract of Driving Record 0 4/26/2017 DL/ID #: 435AA5012 (IA) CDL Permit ClassO�g�.� �+a 224854 Class: D CDL Permit Issue Shrock, Steven Warner Audit #: 9840015 Address: 1512 IST AVE APT 301S Issue Date: 03/08/2016 Expiration 01/17/2018 Date: City/State: CORALVILLE, IA Endorsements: 3 History Information Convictions Date: 522414012 CDL Status: Mailing 1512 IST AVE APT 301S Restrictions: NONE Address: �_'� Restriction None Mailing CORALVILLE, IA Supplement: City/State: 522414012 B61 Date of 1/17/1946 IA Birth: None Sex: M History Information Convictions Date: VAL CDL Status: CDL Permit Non�.� 0 Expiration Date: �_'� CDL Cert Status: None y IA CDL Permit None B61 Endorsements: Johnson IA CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: None CDL Permit ELG Status: 02/03/2015 CDL Cert Status: None CDL Med Status: None Citation Date Conviction Date ACD Explanation County IUR 01/31/2015 02/03/2015 M14 Fail to Obey Traffic Sign/Signal Johnson IA 08/06/2016 09/26/2016 B61 Violation of Accident Requirements Johnson IA Name: Shrock, Steven Warner DL/ID: 43SAA5012 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: ' IOWA -.% 4/28/2017 D. 0. T.:S x®IIIYEd Office of Driver Services