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Home My WebLink About17-164.l IDENTIFICATION NO. / - —trq 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 Fast Washington Sl reel Iowa City. Iowa 52240-1826 Failure to complete rhe "required" Information_ will result in denial of the application (319)356-5040 (3 19) 356-5497 FAX 1. Name (REQUIRED) First W,)�o Middle-Dr-x+r Last 31 �c/-i 2. Address (REQUIRED) —1o10 t-\1�iS�'j�r 54 7 _Eif 3. Contact Information IREQUIRED) Email: _ h, 1) w L�f]�, q cArn, 1, c o —Cell Phone 7319 3 -,?l 8-73C. (All written oommunit:dtia Ant via email) 4a. Driver's License expiration date (REQUIRED) / 5 ��oLg ,I- b Taxicab Business Name (REQUIRED) Uoo // 5. Prior experience in transportation of passengers: [ r - 0 , n f r k t., SI n cG 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense O W What happened to the charge? (Circle one) Where When C» 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 v 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.yearsv V�2 iI Type of offense Where 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide ft 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 hereby certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number fl 3.5 f1/} G Biu/ 6 issued on 1c+ expiring on,o� I understand that if I falsely answer any questions in this application, that this ap lication may be denied. -agree 'e thatin�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 o Title , Chapte , of the Cit Code (Needs to be signed in front of a Notary Public) Signature of Applin rl_ Date a I U ! 7 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by 246-1 on this S day of 1 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 licenseyd ��(0 za—, (�� 0- Signature of Police Chief or designee -217 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. Signature of City 01 rk or designee U l Zf 7 Date N O Office Use Only u r� � a `i; Approved application n� N r DCI report State certified driving record Website update GerhrtMIMNIenDGEnPPLM14.ima.e Doc 0712016 AC Iowa Department of Transportation Office of Dirver;:ernces fTal Free) BW532-1121 PO Box 9201. Des Manes, IA 5O3O6 9204 515-244 9124 FAX 515239183/ History Information CLEAR DRIVING RECORD Name: Barry, William Dexter DL/ID: 435AA6946 Pursuant to Iowa Code 4321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that 1 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: IOWA D. 0. T. Name: Barry, William Dexter DL/ID: 435AA6946 2/5/2017 r4 ,y ;s Office of Driver Services C..1 —q� Iowa Department of Transporation yid � 1 <r v M rn 0..0 W Certified Abstract of Driving Record Inquiry Date: 2/5/2017 DL/ID #: 435AA6946 (IA) Customer #: 3350447 Name: Barry, William Class: D ID Status: EXP Dexter Address: 720 N DUBUQUE ST Audit #: 9658988 DL Status: VAL APT 7 Issue Date: 12/22/2015 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 02/15/2022 CDL Cert Status: None 522451925 Endorsements: 3 CDL Med Status: None Mailing Address: 720 N DUBUQUE ST Restrictions: Corrective Lenses Restriction None APT 7 Supplement: Date of Birth: 2/15/1967 Mailing IOWA CITY, IA Sex: M City/State: 522451925 History Information CLEAR DRIVING RECORD Name: Barry, William Dexter DL/ID: 435AA6946 Pursuant to Iowa Code 4321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that 1 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: IOWA D. 0. T. Name: Barry, William Dexter DL/ID: 435AA6946 2/5/2017 r4 ,y ;s Office of Driver Services C..1 —q� Iowa Department of Transporation yid � 1 <r v M rn 0..0 W Feb. 1. 2U11 4:11VM Uiv of 0iminal Investigation N0.9140 Y. 1 Fro m:a.ny .1 tow& array Ciera vma• 310 3666407 02/02/2017 IO:OG NOtO P.002/000 STATE OFIOWA a Criminal History Record Check Request Form DCI Account Numbei, Cj Op -7— %J -- (if cppliutdc) -' 'ru: Iowa Division of Criminal luveslieation From: City of Iowa City _ ___ Support Opera t iwis But u, I" Flour City Cle'Ws Office 215 P. 7"' Streel 410 E. Wsshlo ton Street Des Moines, louts 50319 (916) 715 lnwsfGityrlA-52340— (515)725-6080 Fax Picone: 319-356-5041 Fax; 319-356-5497 I am re0uesline an Iowa Criminal History Record Check on: Last Name ouwdaion) First Name (mandator)) _ Middle Name (rewmmcndrd) _ IS0,(/'- W , 16 4V'--, bP)( e Date of Birth (mandatory) Gender (mandelo •) Social Security Number (recommendccdd) ';;L I i S) 1 `16 Male ❑Female 5—,TL/ — /I — 5 6 - / Waiver Afornlgfion: 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 comoletd criminal history record information, as allowed by law, always obtain a wafver signature from the sub ect of the rtquest. Waiver Release: 1 herctry give permission for Ne above r-yue Lina official 10 Wndva an lona uimhOl history Moto dace w,M she iUvuioa of erimiml dbyrhe DOmay besdeasldaasrliod b,r Inruuaalion(M) Any uimbulhisiorydots comcrninanlcshot ine�^ /We. v% Wniver signature: Iowa Criminal History Record Check Results As of a search of the provided name and date of birth revealed ® No Iowa Criminal History Record found with DCI 9LIowa Criminal History Record attached, DO 0.. DCI initials r DCI -77 (08125/10) Received Time Feb, 2, 2017 2:39PM Ro,2732 list noly) "'t 7T-1 : 7:1 4 : —4a Feb. 7. 2017 4:11PM Div of Criminal Investigation No. 3146 P. 2 ADDITIONAL IDENTIFIERS CCH RECORD •.. 01 ARRESTED/TAKEN INTO CUSTODY 20000612 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 042157401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA121J.2(A) OPER VEH WH INT (OWI) / SSR MISD / 1ST OFF - CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 042157401 SENTENCE DISP EFF DAT JAIL 2D 20000720 ATT DDS SA EVAL FINE $500 20000720 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 EASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION N C IOWA CRIMINAL HISTORY Tim� .� C-) N r DCI 00622510 m MISDEMEANOR CONVICTIONS ONLY 1> CZ PAGE 1 OF 1 DATE PRINTED- 2017/02/07 DCI:00622510 NAME: BARRY,WILLIAM DEXTER DOB SEX RAC MGT WGT EYE HAIR SKN POB 19670215 M W 509 220 BRO BRO MED MD ADDITIONAL IDENTIFIERS CCH RECORD •.. 01 ARRESTED/TAKEN INTO CUSTODY 20000612 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 042157401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA121J.2(A) OPER VEH WH INT (OWI) / SSR MISD / 1ST OFF - CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 042157401 SENTENCE DISP EFF DAT JAIL 2D 20000720 ATT DDS SA EVAL FINE $500 20000720 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 EASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION N C Tim� .� C-) N r r �m 3 m 1> CZ