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Home My WebLink About17-113 2— IDENTIFICATION NO. / 7 — //l l r 1 (Office Use only) �f.:.�oGr `~`-/ mismirir 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 Strcct 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 Irst M, i.dl� Last 1. Name(REQUIRED) ` L ! r ( t et-N. 2. Address(REQUIRED) 3=5-140-1 14 Z51 3. Contact Information(REQUIRED) Email: r"Lpj4-1 eiYs-e rf c o"^ Cell Phone: C3 tt') 3$3 •-1t40 7 Z tnl9;-1-:v@ ;I.Con (All written communicati6n sent via email) 4a. Drivers License expiration date (REQUIRED) 6thialbie c7 I Z.4 12t 2.v b. Taxicab Business Name(REQUIRED)_. 5. Prior experience in transportation of passengers: -cvS , U///z. ry 6. Have you ever been arrested/charged with any misdemeanors and/or felonies in this State or elset, ere? Type of offense ` Where j tzu What happened to the charge?(Circle one) ;'~'-1 Convicted Dismissed Deferred Suspended Plead Guilty Other.,_— 7. Have you been arrested/charged with any traffic offenses in the last five years? t,04:41-5 Type of offense Where When �►4(— ZviS- What happened to the charge?(Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other o 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? t♦ 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) Cl\h) 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 herebyata . that I have issued to me by the Iowa Department of Transportation valid Driver's license number 4c'ct[:I!"rl, '3 issued on Lelfyfriffa expiring on 4' (ZqI tb2° . 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 1 • ! ' Thr * Date alt.(Z n-R ******Thmr**iitiHii4k1f1 LAS---1ft***ftt**t*****tfY k M-1*1!441 1-11..-k1**t***1*****UANNff}1** 4**Mt44M****** STATE OF IOWA COUNTY OF JOHNSON ) 5Wb cribed and sworn to ore me by 'Arcuu. L.• L LJ:I Sor ` on this of E fi.w ou.r4 Zn( f sietbort. r WEND?3.wan NoVi?Public in ay for the State o owe } tcommissionNumber72W28 co *e****** w n4*****+ ..*.+*.*4e*.4**4*****eft*f:n*e**4a*44*a**a4tnf41t.1*4** 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 4ly'yhoz-o n9)- Signature of Police Chief or designee 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. 2-1%1n re of Cit Clerk orliesignee Date *1**************4******4********4«4444* Office Use Only C, c'e Approved application DCI report c3-1. — State certified driving record ca Website update :< -o ;tri 6;1. GJ •• r CJ DenmuaoRNBAbSEAPRL92OI4omeSet.00c 07/2016 ' . , J ._. , IOWA DOT SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadot.gov Office of Oliver Services PO Box 92041 085 Moines,IA 50306-9204 Phone:515-244-91241800-532-1121 I Fax:515-239-1837 www.lowadot.gov Certified Abstract of Driving Record Inquiry Date: 2/3/2017 DL/ID It: 482LL4953(IA) CDL Permit Class: None Customer if: 3267837 Class: D CDL Permit Issue None Date: Name: Wilson,Brandy Lynette Audit#: 1078131 CDL Permit None Expiration Date: Address: 332 ELLIS AVE APT 28 Issue Date: 06/14/2016 CDL Permit None Endorsements: Expiration Date: 09/24/2020 CDL Permit None Restrictions: City/State: IOWA CITY,IA 52240 Endorsements: 3 ID Status: None Mailing 308 E BURLINGTON ST BOX Restrictions: NONE DL Status: VAL Address: 143 Restriction None CDL Status: None Mailing IOWA CITY,IA 522404528 Supplement: CDL Permit Status: ELG City/State: Date of Birth: 9/24/1976 CDL Cert Status: None Sex: F CDL Med Status: None History Information • CLEAR DRIVING RECORD r‘:'c •: stY,4.e Name:Wilson,Brandy Lynette DL/ID:482LL4953 ,.,:Ci` 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 signatureand the seal of the Department to be set upon this document,at Ankeny,Iowa this date: v� to,.•• 2/3/2017 Volt Office of Driver Servicest• baviewase Iowa Department of Transportation • Name:Wilson,Brandy Lynette DL/ID:482LL4953 • V Feb49.. 2011 2:21PM Div of Criminal Investigation No. 3387 P. 1/6 . II F1?m? ay of row. City CI ark 0Iftc• 310 22.6A•07 02/06/2017' 12:66 .alo P.092/002 //t'r/'e. 1 - e/i/ Ji'`; -/ar(nr:., crC. :Zv/7- Oa- aa ryv . STATE E OF IOWA nom`,.'„►y rf 4,,,,.,,i;;;,,. -- Criminal History Record Cheek ` • . iowA _'.,, ,a c •1. = Request Form ..•-.'�.•:`•-Q _w1tNr-.r�” 41,pi 1 DC1 Account Number: I ` F (if applicable) To: lows Division of Criminal Investigation From: City of Iowa Cit} _ Support Operations Bureau,1"Floor City Clerk's Office 215 a.74 Street 410 C.Washington Strcrt .-- Des Moines,Iowa 50319 (5+ )725 6056 _feud E I1, in 52240 (515)92S-6080 Far Phone: 319-356-5041 Fax; 319-3356.5497 1 am requesting an Iowa Criminal History Record Check on• Last Name (mandatory) First Name(mandatory) Middle Name((commended) L' I coliy7 C -c. L - 1 e.ti Date of Birth (mandatory) Gender (n„ndatory) w Social Security Number (recommendcdl f7(1 1 lel 1 ii OMa'e NFemale Lig) - Lo - `-/ 2- j Waiver Isiformalian: Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history record information,as alloyed by law,always obtain a waver signature from the subject of the request. _ Waiver Release:t he et y give permission tot the above requesting official to conduct an tow.criminal history record meek t)id,the Di,mon of Criminal tmwestivition(DCI). My criminal histety dela concerning me that is maintained by Uu DCI may be rslcased et alloned by lew. Waiver Signalln•e:3-;-G-wI y' " VZ1t'd �:Z�t7 r rrr hM1t,rc�t� , a.c J Iowa Criminal History Record Check Results (Dm,,,,.o,,,,.) As of 1 C- i I '7 . a search of the provided name and date of birth revealed: 0 No Iowa Criminal History Record found with DCI • • A.: • 131, Iowa Criminal History Record attached, DCI # 5'())R if? I)C) initials_ DC1-77 (08/2S/10) P,P, ivatl Tiir,c Fel, A. 11117 11.1cPU Nn 10Od • m ' YeD. Y. jun[VII [:itrm Lily 01 Lrrminar inves:iga: iUn nY. 3301 :117 — tel . e IOWA CRIMINAL HISTORY DCI 00593186 MISORNRANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- • 2017/02/09 DCI:00593188 NAME: WILC0N,BRANDY LYNETTS DOB SEX RAC HGT WGT EYE HAIR SEN POB 19740924 F W 507 145 SRO BRO PAR IA 19760924 ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y SC ARDOR SC ARM CCH RECORD ••• 01 ARRESTED/TAKEN INTO CUSTODY 19990303 AGENCY: IA0250000 DALLAS CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 1ST OFFENSE TRK#: 040710601 COURT DISPOSITION AGENCY: IA025015JDALLAS CO DIST COURT COUNT NO- 01 IA STATUTE: IA3210'.2 OPER PER WH INT OWI COURT CASE ID: OWCRD22960 CHARGE CLASS: MISDEMEANOR CONVICTION TRX#: 040710601 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 19990708 FINE $1000 19990708 02 ARRESTED/TAKEN INTO CUSTODY 20021218 AGENCY: IA0250100 PERRY PD \"�1� CHARGE NO- 01 IA STATUTE IA123.46 IN PUBLIC TOX `d" TRX#: 061696601 COURT DISPOSITION AGENCY: IA025015J DALLAS CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION COURT CASE ID: 05251 SMAC045665 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 061696601 SENTENCE DISP EFF DAT FINE $100 20030113 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OP IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON-LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OP FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OP YOUR INQUIRY. ' Feb. 9. 2017 2:21PM Div of Criminal Investigation No. DU/ Art' t =VISION OF CRIMINAL TM'VESTIOATION C�