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Home My WebLink About17-125r IDENTIFICATION NO. 1-7 —1 a5 1 l 1 (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made between 8 a.m. to 3 p.m., Monday— Friday) 410 East Washington Street Iowa City, Iowa 52240-1826 Failure to complete the "required" information will result in denial of the application (319) 356-5040 (319) 356-5497 FAX ...First�(� lddla Last 1. Name (REQUIRED) �1C)5kkcr Thama� 2. Address (REQUIRED) 1L{01 zyl p 3. Contact Information (REQUIRED) Email: )f7S 14 . 7am5z! Fir 9 vra h0e)..er+ Cell Phone: 0 � 5 as "0 o d (� (All written comffiunicatiM sent via email) 4a. Driver's License expiration date (REQUIR�E/D)0'7/27/ 2oda b. Taxicab Business Name (REQUIRED) / ell O(A) 6 a{2 04 JOWCA C 5. Prior experience in transportation of passengers: /1/0, 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_ Otht�, 7. Have you been arrested / charged with any traffic offenses in the last five years? =[?} , Type of offense Where ejj� '"{n Gn What happened to the charge? (Circle one) N Convicted Dismissed Deferred Suspended Plead Guilty Ot6t+ 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? n G Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) no 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 Zgel xtZ tth I hre issued to me by the Iowa D apartment of Transportati n a valid Driver's license number j f t zp issued on d$ I Jo IR expiring on 07 , -f 1 understand that if falsely answer any questions in this application, that this applica ion may be denied. I gree 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, Chap r 2, of the City Code. (Needs to besignedin front of a Notary Public) Signature of Applicant Date 7 �� STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by S Ss6 ao n. on this �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 Cj�(of Iowa City (Title 5, Chapter 2, City Code). tof iver's icense e Ch' designee D to 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. {G C a 7)L -cJ� Signature of City Wk or designee Office Use Only Approved application DCI report State certified driving record Website update Date Cler nAXIDRN3ADGEAPPL92014am ded.DOC 07/2016 N O °fin rn r -- o `} N W Cler nAXIDRN3ADGEAPPL92014am ded.DOC 07/2016 Iowa Department of Transportation AC Orrice of Orrver Servrces (Toll Free) WO -532-1121 Pa Box 9204, Des Manes, to 5030&9204 515-244.5124 OFAX' 515-2391837 CLEAR DRIVING RECORD Name: Ramseyer, Joshua Thomas DL/ID: 207ANS625 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: 8/23/2017 IOWA -% oil �f + :oo0 !'� �r ,' Office of Driver services Iowa Department of Transporation Name: Ramseyer, Joshua Thomas DL/ID: 207AN5625 Certified Abstract of Driving Record Inquiry Date: 8/23/2017 DL/ID #: 207ANS625(IA) Customer #: 6672038 Name: Ramseyer, Joshua Class: D ID Status: None Thomas Address: 1401 2ND ST Audit #: 2075625 DL Status: VAL Issue Date: 08/18/2017 CDL Status: None City/State: CORALVILLE, IA Expiration Date: 07/27/2022 CDL Cert Status: None 522411829 Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 1401 2ND ST Restrictions: NONE Restriction None Supplement: Date of Birth: 07/27/1988 Mailing CORALVILLE, IA Sex: M City/State: 522411829 History Information CLEAR DRIVING RECORD Name: Ramseyer, Joshua Thomas DL/ID: 207ANS625 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: 8/23/2017 IOWA -% oil �f + :oo0 !'� �r ,' Office of Driver services Iowa Department of Transporation Name: Ramseyer, Joshua Thomas DL/ID: 207AN5625 0�1. Aug. 30. 2017, 4:05PM Div of Criminal Investigation No 9690 P. 1/1 .. .0.. .,,.. Cab .,� ..�.r (Fak)3153„�2i.,.. . .!Z. 11002 • it �� /'4` 1�• STATE OF IOWA Criminal History Record Check Request Form *� DCI Account Number: 9967-F (Iroppiwble) To: Toho Division of Criminal Investigation Fromi Yellow Cab of Iowa Clty Support Operations Bureau, t" Floor PA Box 428 215 B. Ph Street _ Des Moines, Iowa 50319 Towa City, i4, 52244 (SIS) 725.6066 [S1 SL22 Phone: Fax: (319) 339-7302 I am renuesrina, nn Inwn f:rlml..al t7larn.., 1) AA ...t r•t.e,.t...... Lme (mandmo ,First Name (mandaro ' Middle Name (recommandcd .k VIVQ:� T/ti o ►n a 5Birth(mendsiolry)) Gendar momendmo 'Soclal•Seeuri Number/(recommended) a 9 Q, U Male ❑Femi le S55 -0 �3 (� WalvePInfDPNiafion, Without a signed waiver from the subject of the regpest, a complete grlminal history roeord may hot be releasable, per Code of Iowa, Chapter 692.2. For complete criminal hletoryrecoro Information, a6 allowed by law, alwaya obtain a waiver s1 nature from the subject of the request. ' Waiver Release: i horebygive petmisslon foriho Above roquesl(ng offteld to candual an lows criminal h)smry record chock w)ds the Divirion are Invc/ligation (DCQ, Any orlminol hlalory dale concerning me pt is malntalne by the DCI may be released as allowed by law. Walver Signature; .67 (DCI uce only) As of S 1 �X)c I V� , a search of the providtd name and date of birth revealed: FNo Iowa Criminal History Record found with DCI El lowa Criminal History Record attached, DCI # DCI initials. DCI.77 (08/25110) Received Time Aug, 28, 2017 10:200 No, 5646.. —