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Home My WebLink About17-160r IDENTIFICATION NO. (-I- (b0 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 rst + 1. Name S� Addle 1 Last ^I ��e (REQUIRED) 0 U FL4Cnln Cd 2. Address (REQUIRED) r r 3. Contact Information (REQUIRED) Email .SI^afo 2 4yNat', C Upsell Phone of ` UOS ( wriJJ� ttenc m unication gent via email) 4a. Driver's License expiration date (REQUIRED) 6-1-) —C) I / b. Taxicab Business Name (REQUIRED) -Ye I/auJ Cel 5. Prior experience in transportation of passengers: A10 M to 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State iFelsewh'ere? Type of offense �n o Where r-" Po5S�S5 (-j VA MG:t 1�k )0, tn(-A ;r' ✓ice <rrri a M What happened to the charge? (Circle one) Convected 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 / f r ! - What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended lead Guilty ther 8. Has your drivers license or chauffeur's license been suspended or revoked in the last 1ve years? /tic) 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) 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 j t APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hey eby,_cP{tii�t)yat I have i ued to me by the Iowa Department ent ofpTragnsportation aalid Driver's license number iD `I f t lX� /� issued ony - ex irin on 0(,-/)-C2615 . 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 agre,e4hat, if authorization to be a taxicab driver is granted, to comply at all times with all of the provisio of Title 5, Chap r 2, of e City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Daty(f11-0/-olpf% a, 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 Drivers license Signature of Police Chief or designee z 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. s � 2 Si nature of City Clerk r designee Da e lfH4fH44fHlHllffHf444H11111HflHlH111H!llN1f*-*11f*-IIHfHffHffHfHH#HffHfHHH#!ff �#4441f#f i44f#*Yff fklH4*4Hf 4f llff#i*HHt4H Office Use Only Approved application DCI report State certified driving record Website update C�ry AXIMNS DGEAPas20immmaea.00C 07/2016 N O !!RH#1H#fHflHlHlfHflflHlHlHfHf!#1f1f1*-1-Ri1#fH#f*-kf###t!##1f##t####fe*#RHtHf#*f ##H##ffH##HffH# *®llfHf*fliFfHH***H*#####HH# STATE OF IOWA ) D m TI COUNTY OF JOHNSON ) n Subscribed and sworn to before me by _Tr, uo- . Slno-roc OR<this -T day of -7 r)i -1 .. Mnr s. tint .ze L c _ m G� <ca-. � � C� a, 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 Drivers license Signature of Police Chief or designee z 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. s � 2 Si nature of City Clerk r designee Da e lfH4fH44fHlHllffHf444H11111HflHlH111H!llN1f*-*11f*-IIHfHffHffHfHH#HffHfHHH#!ff �#4441f#f i44f#*Yff fklH4*4Hf 4f llff#i*HHt4H Office Use Only Approved application DCI report State certified driving record Website update C�ry AXIMNS DGEAPas20immmaea.00C 07/2016 Nov, 29. 2017 1:29PMnteYDiv of Criminal AIooes�tigation ,1,28/2017,6;2@0.72442" "1.002/002 4/5 . Fr_....-... 2 .7 1 .......e K:d•'SiSCq,a STATE OF i 1 Y r`f IIown� Crikilinal History .n t. .t; Check Request Form' (if applicable) To., lows Division of Crinllnal Glvestigatlon Support Operations Bureau, 0 Floor 215 E. 71" Street Des Moines, lova 50319 (515)725-6066 (515)725-6080 Fax I am requesting an Iowa Criminal -/,7 -/5 ?6 From; city oflowacity City Clerk's Office 410 E, Washin on Street Iowa City, IA 52240 Phone: 319-356-5041 Fare 319-356-6497 �I emale I Y 0 W(fiverlu001mafion" 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 comufete criminal history record ie(ormatlon, as allowed by law, always Waiver Aelease:1hcrc6ygive permission for [be ahovcrcIrbut lls001 ialtoeondoctmlowacriminalhinoryrecordcheckwiththoDivisionofC urinal Investtgallon(DC). My criminal history data eoneomin me that is maintained by lh uCi maybarelcased asallowed bylaw, Waiver signature: �L. Iowa Criminal History Record Check Results (DCtasbonly) As of l • ZR . �" , a Search of the provided nine and date of birth revealed: ❑ No Iowa Criminal History Record found with DCI Iowa Criminal History Record attached, DCT # (Ci:fi :E+Ca 1'1 to _, U7 DCI initials�.-3 r,.,- _. DCI -77 (08/25/10) r - w Received Time Nov.28. 2017 2i00PM No -0640 r Nov, 29. 2017 1:29PM Div of Criminal Investigation No, 7244 P. 5/5 IOWA CRIMINAL HISTORY DCI 00484305 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2017/11/29 DCI:00484305 NAME: SHRROD,JOSH SHEROD,JOSHUA RYAN DOB SEX RAC HOT WGT EYE HAIR SKN POE 19760617 M W 509 150 ORN PRO MED IA ADDITIONAL IDENTIFIERS TAT OL ARM CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19940807 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION SCH I -MARIJUANA TRK#: 013116201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124-401 POSS SCH I-NARIJ CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 013116201 SENTENCE DISP EFF DAT FINE $250 19941128 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA321J-2 OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 013116202 SENTENCE DISP EFF DAT JAIL 48H 19941125 FINE $500 19941128 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 PURNXSHED, WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY, DIVISION OF CRIMINAL INVESTIGATION d�L r ARTS rage 1 ul 2 C,J10WAD0T wwwJowadot ov SMARTER I SIMPLER 1 CUSTOMER DRIVEN Office of Driver Services PO Box 9204 1 Des Moines. LA 50306-9204 Phone: 515-244-9124 1800-532-1121 1 Fax: 515-239-1837 www.lowadot.gov Inquiry 11/28/2017 Date: Restriction None Customer 2735096 Endorsements: CDL Permit Name: Sherod, Joshua Ryan Address: 2205 MIAMI DR City/State: IOWA CITY, IA None 522406770 Mailing 2205 MIAMI DR Address: Mailing IOWA CITY, IA City/State: 522406770 Date of 6/17/1976 Birth: Sex: M Convictions Certified Abstract of Driving Record DL/ID #: 059AA2714 (IA) CDL Permit Class: None Class: D Audit #: 2343990 Issue Date: 11/28/2017 Expiration 06/17/2019 Date: Endorsements: Chauffeur 3 CDL Permit Issue None Date: CDL Permit None Expiration Date: Restriction None CDL Permit None Endorsements: CDL Permit CDL Permit None Restrictions: Iowa ID Status: None Restrictions: NONE DL Status: VAL Restriction None CDL Status: None Supplement: CDL Permit ELG 'Speed (10 mph & under in 35-55 mph zone) Status: Iowa CDL Cert Status: None CDL Med Status: None History Information Citation Date Conviction Date ACD Explanation JUR County 05/28/2016 !07/11/2016 S92 'Speed (10 mph & under in 35-55 mph zone) SA Iowa Name: Sherod, Joshua Ryan DL/ID: 059AA2714 (IA) 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: �:• ••"' ••.`r6/ °4 11/28/2017 IOWA D. 0. T. OANEA Office of Driver Services Iowa Department of Transportation http://172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 11/28/2017