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Home My WebLink About15-135 (2) IDENTIFICATION NO. 1-1`t3Z-- ' I - 1 (Office Use Only) ...-.elli ®alt ,121 'k MIM lIg r�� CITY OF IOWA CITY APPLICATION FOR TAXICAB/MOTORIZED PEDICAB VEHICLE DRIVER (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 / Middle Last 1. Name(REQUIRED) Pa,�`(r 1/6" /7491,17r r - 2. Address(REQUIRED) 7 y Sip //it S'" Si�,,� 4 i y .L. 3. Contact Information(REQUIRED) Email: ‘.. r 8 A , Cell Phone:3/f L/6/ /!�(All r tten commation sent via email) 4a. Driver's License expiration date (REQUIRED) 0 1-0Y-205 b. Taxicab Business Name(REQUIRED) K /(,,,,i at b 61a, CI f- 5. Prior experience in transportation of passengers: f /Veil if c7r (/U )J . � ,--1 c c,-<7. t 6. Have you ever been arrested/charged with any misdemeanors and/or felonies in this State or8tewliere? rn f' t Type of offense Where • h n pw,y Johvtsn Cu Isle 5 Pt ioL cc, i n-i-cy wa,s,htizi+4,1 b.) 3-1 it, I1 q ala 1 What happened to the charge?(Circle one) uuic sr �F Oil,j>s-65► PI31t qq o I 13 l I q a U �� 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 Where When • l e0 vv r ' ‘KiI y 21haron c--& 6 - q',3 What happened to the charge?(Circle one) Convicted Dismissed Deferred Suspended Plegitrilq Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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) 40 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 r �bbi! °rz.01 n-) t-+nsutAos 'ac-el4 4 Z h 6 i f I N (r)LA2cfluvtichlryl Hoe sc e 4. APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportatio a valid Driver's license number / ,- t1 C 120,79 issued on �7- Q /S expiring on - . I understand that ifI falsely answer an questions in this application, that this applica on may be denied. agree hat 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 (931/ 7J Date /0-3---/7 ********************************************************K***********************AAAAAA********************************t***********f A..*....**** STATE OF IOWA COUNTY OF JOHNSON ) _Subscribed and sworn to before me by o on this day of `Notary : blic in and for the State of Iowa t**#************AAAAAA k***********************#t***** ,*M1*************t*k********************,I AAAAAAAA k******************* 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). Expiratigthldate of r, ' cense q/2 // 2_) Sign- e • Police Chief or designee Date 0/1// 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. c E-G�-e /rO / 7 ignature of City Clerk or4gnee ( Date ***************k************** *************************************************A A A A A A*******************A* ********************* Office Use Only N C> Approved application DCI report State certified driving record c->—‹ Website update -1C'') w _gym >a l . Q .-h Clerk/TAXIDRIVBADGEAPPL92014amended.DOC 0716 4 w , DOT SMARTER I SIMPLER I C www ioWadotgov CUSTOMER DRIVEN Office of Driver Services PO Box 9204 I Des Moines,IA 50306-9204 Phone:515-244-9124 i 800-532-1121 I Fax:515-239-1837 www.iowadoLgov Certified Abstract of Driving Record Inquiry Date: 9/27/2017 DL/ID#: 127AC6033 (IA) CDL Permit Class: None Customer#: 1934738 Class: D CDL Permit Issue None Date: Name: Toomer, David Alan Audit#: 9285470 CDL Permit Expiration None Date: Address: 2742 500TH ST SW Issue Date: 07/28/2015 CDL Permit None Endorsements: Expiration Date: 09/21/2023CDL Permit None Restrictions: City/State: KALONA,IA 522479214 Endorsements: Chauffeur 3 ID Status: EXP Mailing 2742 500TH ST SW Restrictions: Corrective Lenses DL Status: VAL Address: Restriction None CDL Status: None Mailing KALONA,IA 522479214 Supplement: CDL Permit Status: ELG City/State: Date of Birth: 9/21/1956 CDL Cert Status: None Sex: M CDL Med Status: None History Information Convictions Citation Date Conviction Date ACD Explanation 11/17/2013 County 12/09/2013 IA N82 Improper Backing IA Johnson Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date JUR Case Number 11/17/2013 _ IIA 1767955 06/10/2015 'IA -- ---- 01/29/2016 rIA863060 904490 Name:Toomer, David Alan DL/ID: 127AC6033(IA) 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: vttgczt " %o4' ..4% 9/27/2017 �' IOWA ``.€ yatD. 0. T. ,-' P' ''rlO :mss' 'ic�f D211AgRu-S owaeof Driver Department eoflTrs ansportation Name:Toomer, David Alan DL/ID: 127AC6033(IA) (FAX)3193332703 P.002/002 • �'i "�"`` STATE OF IOWA , ''it s'" Criminal History fi ° ,r,��itatvil tri y Record Check °,+ s f7s `' Request Form ... DCI Account Number: 9967_F To: Iowa Division of Criminal Investigation tit applicable) Support Operations Bureau, 1a'Floor Promi Xa]!ow Cab of Iowa Cl 215 E.7th Street P.O.Box 428 Des Moines, Iowa 50319 (515)725.6066 Iowa City, IA, 52244 Phone: Fax: (319)339.7302 I am re•uestin: an Iowa Criminal Histo Record Check on: Last Name(mandato r Date of Birth (menamary) p, Gender(mandate ) •Sociai•Secu ' Number(reeommended) / ''Z� —S4 �Maie Cremate • T•Yaiverin ormafion: • ��^2- ! d f Without a signed waiver from the subject of the request,.2 complete Criminal history record may not be releasable,per Code of Iowa,Chapter 692.2, For corn Marg criminal hlstory.record Information,as allowed by law,always obtain a waiver sl:nature from the sub act of the re.uest. • Waiver Release.I hereby give permission for the above requesting official to conduct en Iowa criminal history record check with the Division of Criminal Investigation(DCI), Any criminal hinory data concerning mo that Is meintained by the DCI may be released es allowed by law, Waiver Signature; • Iowa Criminal Ristor Record Check Results • As Ofla , • (Dm use only) a search of the provided name and date of birth revealed: 0 No Iowa Criminal History Record found with DCI _ u Iowa Criminal History Record attached, DCI# DCI initials,, DCI.77 (08/25/10) ceived Time Sep. 25. 2017 4: 54PM No. 7409 IOWA CRIMINAL HISTORY DCI 00209152 MISDEMEANOR CONVICTION.i OZTLY PAGE 1 OF 3 DATE PRINTED- 2017/09/27 DCI:00209152 NAME: TOOMER,DAVID ALAN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19560921 M W 511 200 BRO BRO MED IA ADDITIONAL IDENTIFIERS SC CHIN SC R KNEE CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19780203 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRK#: L10173201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: OPERATE MOTOR VEHICLE UNDER INFLUENCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173201 SENTENCE DISP EFF DAT JAIL 10D 19791120 02 ARRESTED/TAKEN INTO CUSTODY 19860716 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L10173401 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173401 SENTENCE DISP EFF DAT JAIL • 2D 19860717 03 ARRESTED/TAKEN INTO CUSTODY 19901103 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L10173501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173501 SENTENCE DISP EFF DAT DCI 00209152 PAGE 2 OF 3 JAIL 2D 19910214 FINE $500 19910214 CREDIT W/TIME SERVED 14H 19910214 04 ARRESTED/TAKEN INTO CUSTODY 19901103 A AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-263 LEAVE SCENE OF ACCIDENT TRK#: L10173601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321-261 LEAVE THE SCENE OF PERSONAL INJURY ACCIDENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173601 SENTENCE DISP EFF DAT JAIL 1OD 19920214 CREDIT W/TIME SERVED 14H 19920214 05 ARRESTED/TAKEN INTO CUSTODY 19921001 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI/2ND OFFENSE TRK#: L10173701 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE: OWI/2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173701 SENTENCE DISP EFF DAT JAIL 30D 19930129 FINE $750 19930129 06 ARRESTED/TAKEN INTO CUSTODY 19931126 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED TRK#: 006588001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-21 DRIVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006588001 SENTENCE DISP EFF DAT JAIL 2D 19940304 • DCI 00209152 • PAGE 3 OF 3 FINE $250 19940304 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