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Home My WebLink About17-0931 Z I CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319)356-5497 FAX 1. Name (REQUIRED) i 2. Address (REQUIRED) IDENTIFICATION NO. Z— (Office Ose 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) 4a. Driver's License expiration date (REQUIRED) / b. Taxicab Business Name (REQUIRED) i �m 5. Prior experience in transportation of passengers: - kQ - rw,20 t- ] ?1"I S -99s6 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Iv 0 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? 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? 9t N T_yae of offense Where E5 z Q cWhen T 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, pleasRl'` idt3 �C) o 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 certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number a`zz73 19.13 issued on Q�Sexpiring on fM.l'K202n . 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 provision(s� of Titlly 5, Chapter 2, of the �City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant�r `Vf��o`I" !>» (I y� Date Oi � 3 wI� +....:..............m,,,,.:...m*+.:r.:.K..e++a.:+.:.rk.,,,.r.:r...,.:a...:.»„�...Ne„:.�n++....,++....+,+...N..,,,,......++,..+.r... STATE OF IOWA ) COUNTY OF JOHNSON ) n 1 1 Subscribed and sworn to before me by �' �� 1� o Q ��\\' �r4nk+Non this l3}h day of S�t� aor-i in and for the State of Iowa 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 ti 0 �n Signature of Police Chief or designee D "- r C-) -C r AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAffW4 �VVACIT4"R NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. -'a Zt Cn Signature f City Clerk or designee Date Office Use Only Approved application DCI report State certified driving record Website update ClerknAXIDRNBADCEAPPL92014e ndetl.DOC 07/2016 C4J10WA00T VVVVVI/ OW 9 ed0 0v SMARTER 15IMPLER I CUSTOMER DRIVEN Office of Driver Services PO Box 9204 1 Des Moines, IA 50386-9204 Phone: 515-244-9124 1 800.532-1121 I Fax: 515-239-1837 www.bwadot.gov Inquiry 7/13/2017 Date: City/State: Customer *: 4159890 Name: Nocentelli-Franklin, 522407227 Felicia Colette Address: 2874 TRIPLE CROWN LN Restrictions: NONE APT 3 Certified Abstract of Driving Record DL/ID #: 883zz3783 (IA) CDL Permit Class: None Class: C Audit 7t: 9060926 Issue Date: 05/05/2015 Expiration 04/18/2020 History Information CLEAR DRIVING RECORD Name: Nocentelli-Franklln, Felicia Colette DL/ID: 883zz3783 CDL Permit Issue Date: CDL Permit Expiration Date: CDL Permit Endorsements: CDL Permit Restrictions: ID Status: DL Status: CDL Status: CDL Permit Status: CDL Cert Status: CDL Med Status: None None None None None VAL None ELG None None Pursuant to Iowa Code 4321.10, 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: v o_ O � 7/13/2017 C IOWA•`• ."'.. r D. 0. T�-° n aD ••••... Office of Driver Services _�� _ Iowa Department of Transportatiz �*+r•E cn Name: Nocentelli-Franklln, Felicia Colette OL/ID: 883zz3783 Date: City/State: IOWA CITY, IA Endorsements: NONE 522407227 Mailing 2874 TRIPLE CROWN LN Restrictions: NONE Address: APT 3 Restriction None Mailing IOWA CITY, IA Supplement: City/State: 522407227 Date of 4/18/1980 Birth: Sex: F History Information CLEAR DRIVING RECORD Name: Nocentelli-Franklln, Felicia Colette DL/ID: 883zz3783 CDL Permit Issue Date: CDL Permit Expiration Date: CDL Permit Endorsements: CDL Permit Restrictions: ID Status: DL Status: CDL Status: CDL Permit Status: CDL Cert Status: CDL Med Status: None None None None None VAL None ELG None None Pursuant to Iowa Code 4321.10, 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: v o_ O � 7/13/2017 C IOWA•`• ."'.. r D. 0. T�-° n aD ••••... Office of Driver Services _�� _ Iowa Department of Transportatiz �*+r•E cn Name: Nocentelli-Franklln, Felicia Colette OL/ID: 883zz3783 F JUI. 2011w 2; 31PMc orDiv of Criminal Investigation No.4574 P. 1/9 06/27/2017 09:b� .106.- 2/002 STATE OF IOWA Criminal History Record Check Request Form To: Iowa Division of Criminal hrvestlgadon Support Operations Bureau, 1`t Fioor 215 E. 7'h Strect Des Moines, tows 50319 (515)725-6066 (515) 725.6080 Fax 1 am reauesline an Iowa Criminal History Record Check on: r� "0 DC] AccountNuatber:12e,7 -,_ (if epptembla) From: City of Iowa City City OWN office 4I0 E. Washington Sheet Towa City, lA 52240 Phone: 319-356-5041 Fax: 319-3565497 Name (ma„dnalory) First Name (n,andnloty) Middle Name (recommended) ,1Last NDQzrt�elli' rCah Ct1 of Birth(mb,datory) Gender (mandatory) Social Security� Number (reeommm6ed) /Date "i e) (qV0❑1Vlale Female . Waiver Information: Wi(hout a signed walver from the subject of the request, a complete criminal history record may not be releasable, per Code of lova, Chapter 692.2. For complete criminal bistory record Information, as allowed by law, always obtain a waiver si nature from the subject of the request, I f-'atver Release: 1 hereby give pumission for the above requesting oericial to conduct M Iowa Criminal history record check with the Division ofUnihml investigation (DCI). My criminal history dao concming me that is maintained by the DCI may be released as allowed by law. Waiver Signature 0,&,-I� o u �% Iowa Criminal Histonr Record Check Results (DCI use only) As of � 1 _, a search of the provided name and date of birth revealed; Pr'�No Iowa Criminal History Record found with DCI--. . ❑ Iowa Criminal History Record attached, DCI DCT initials_;;; _ o v ��.-„ tea, ,r ) Received Time Jun.27, 2011 9:32AM No -4040 L