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Home My WebLink About17-166� r , CITY OF IOWA CITY 410 Last Washington Street Iowa City, Iowa 52240-1826 (319) 356-SO40 (319) 356-5497 FAX 1. Name (REQUIRED) _ IDENTIFICATION NO. J-7— 1 IP (0 (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) Failure to complete the "required" information will result in denial of the application First Middle 2. Address (REQUIRED) 51$ o D TC 5a: 3. Contact Information (REQUIRED) Email: r��tgmricc„yal�, c (All written communication sent via 4a. Driver's License expiration date (REQUIRED) 04/////2Z Ra b. Taxicab Business Name (REQUIRED) Ye -1 5. Prior experience in transportation of passengers: 3 ^0,7A-5, u s Q c kn c,A� (/ n ao(3. Last Cell Phone: 319 Y99 71Y9O U 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? 3 Type of offense Where When "t(566A+eeljais -i&M ohe evenf i/J/r14�[!Sef�e�+6��.l��e��j��i. >/6 v/( 3: !'41*'se i%Ke/�sennanl', h9rw.sfrurl.i', aGssa✓At. What happened to the charge? (Circle one) gtiq k- /7 y -0Li e -r` / r Convicted Dismissed Deferred Suspended Plead Guilty Other Have you been arrested Erge ith any traffic offenses in the last five years? ec-.&41J Type of offenseW here 9 c 5 W hen What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended PleadGuil OtheF.., 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five y rs? cZWCE) r' •n -7% Type of offense Where 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please 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 valid Driver's license number ��9 YYa9�ss issued on a 410 2 //y expiring on ii I understand that if I falsely answer any questions in this application, that this applicati n 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 provisionsof Title Chap er 2, of the City Code. (Needs to be signed in front of a Notary Public) i Signature of Applicant_ _ �� Date_ /2/�? 07 #Mll111!111M!!Mf!!M!Mllfififi!!*****####M#####illMlMMlMSfi#fiMMfilMf:M*#**:H'*##M##M###lMMflMff!llfiMf!#YflMf'#*fif*###*####!!!#M#Mf STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by L [Aerrhoi ck A-, on this 7 day of Tl?r-Frithel Zt�(-7 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 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. 0.e n IMIVBADGEAPPL.92014 .dm .DOC 07/2016 �Sigihature of City Clqfk or designee 112-01)7 Date 0 (DYlf MiF3'�M11M`fi`=�1'fj-#' om � i Office Use Only tv r -tn C10 a. M Approved application DCI report ::5,% State certified driving record o Website update no 0.e n IMIVBADGEAPPL.92014 .dm .DOC 07/2016 Dec.14. 2011 8:19AM Div of Criminal Investigation No.8683 Y- 1 Frerrm:Clcy DI Iowa Clly Clerk 1J1110a ale 3666497 12/13/2017 12:10 0319 P.002/002 STATE OF IOWA Criminal History Reepyll Check @ Request Porde To: Iowa Dlvislon of CYImlaal Investigation Support Operations Burenu, I1' Ploor 215 E. 7'a Street Des Moines, laws 50319 (515)725-6066 (515)725-6060 Fax I am renuestinn an Tnwa Criminal Histary Reanrd Check on- DCI Account Number: -YJ2P -z—_— (itapplieable) Prom: City of Iowa City City Clerk's Office 410 E. Washington Street Iowa City, IA 52240 Phone: 319356-5041 Pax: 319.356-5497 Last Name (mandatory) First Name (mandatory) Middle Name (iw,mmendw) 'Ipse ad 1 As of I "t' a search of the provided name and date of birth reve d {yJ/i�t' 04-,4e 1 !G /"O/'l bate of Birth (mandatory) Gender (mandatary) Social Security Number (recommended) 7 � // — % 7 Male ❑Female Waiver Information. Without a signed waiver from the subject of the regue5t, a complete criminal history record may not be releasable, per Code of Iowa, Chapter 692.2. For complete criminal history record information, as allowed by law, always obtain a walver signature from the sub ect of the request. Waiver Befease: i hereby givepermtsslon fol the above reii"aling officialla conduclac, Iowa crimhlal hiilory record cheek with lbe➢ivision ofCriminil InvesligeCion (DCp. any eiminel history dila coneemias me hat i's rnsialsincel by she-DCl may be released as allowed by law. Waiver Signature: Iowa Criminal History Record Check Results M 'Ipse ad 1 As of I "t' a search of the provided name and date of birth reve d m ® No Iowa Criminal History Record found with DCTCID \_ b 4 b a Iowa Criminal History Record attached, ncl a DCI initials DCI -77 (osi25110) D—:.,�A T:— n.. 0 1n13 10•AAAM Ml lzAA 0ec.14, 201/ U,19AM U i v of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00507646 FELONY CONVICTION PAOE 1 OF 1 DATE PRINTED - 2017/12/14 DCI:00507646 NAME: HAMRICK,CHAD HAMRICK,CHADWICK AARON DOB SER RAC HOT WGT EYE HAIR SKN POB 19770411 M W 508 165 BRO SLK LGT IA ADDITIONAL IDENTIFIERS No. U6U3 N. 2 CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19950916 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 02 IA STATUTE IA708-7 HARASSMENT TRK#: 022450902 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 02 IA STATUTE; IA708-7 HARASSMENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 022450902 SENTENCE DISP EFF DAT FINE $100 19961024 02 ARRESTBD/TAKEN INTO CUSTODY 19980902 AGENCY; IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA713-6 ATTEMPT BURGLARY 2ND DEG TRK#: 037241001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: I4713-6(2) ATTEMPT BURGLARY 2ND DEG CHARGE CLASS: FELONY CONVICTION TRK#: 037241001 SENTENCE DISP EFF DAT COURT COSTS 19990226 PROBATION 2Y 19990226 SUSPENDED 5Y 19990226 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 `a ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OP FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS;;EC'0 O rn BASED ON INFORMATION FURNISHED, WE CANNOT CONFIRM OR DENY THAT THE RECORD>� N COVERS THE SUBJECT OF YOUR INQUIRY. ,_,rte Co DIVISION OF CRIMINAL INVESTIGATION 73 Cao ARTS v Page 1 of 2 /,itoota10WA► DOT SMARTER I SIMPLER I CUSTOMER DRIVEN www.lowadotgov Office of Driver Services PO Box 9204 I Des Moines, IA 50306A204 Phone: 515-244-9124 1800-532-11211 Fax: 515-239-1837 www.iowadol.9w Inquiry 12/12/2017 Date: Customer 2349835 Name: Hamrick, Chadwick Aaron Address: 2518 INDIGO DR City/State: IOWA CITY, IA 522406808 Mailing 2518 INDIGO DR Address: Mailing IOWA CITY, IA City/State: 522406808 Date of 4/11/1977 Birth: 04/11/2022 Sex: M Convictions Certified Abstract of Driving Record DL/ID #: 769YY2955(IA) CDL Permit Class: None Class: D Audit #: 7661903 Issue Date: 01/02/2014 Expiration 04/11/2022 Date: None 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: ID Status: None Restrictions: NONE DL Status: VAL Restriction None CDL Status: None Supplement: CDL Permit ELG Status: CDL Cert Status: None CDL Med Status: None History Information Citation Date Conviction Date ACD Explanation JUR County 01/05/2015 02/03/2015 M14 Fail to Obey Traffic Sign/Signal IA Johnson Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date -Y "" Case Number o.k.7a.. 06/07/2014 Tee[;A,-br c0.^, IA 802293 08/20/2014 /,r Jo w, •wt✓ewwrogyiv/lnny o� nw y IA 813321 07/22/2017 Se;.Z✓e - �{o w1 e4'��-/ IA 994283 r-{' IN 4L -A n+V J Cis o w w / C4/ / V Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 (IA) :;E C-)C=1"TY --a C-3 1 !V Pursuant to Iowa Code §321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Depart'algnf of Canspo ation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this isa bTe and accurdiGgrcppy of an official record currently in the custody of said office, and that I have been authorized by the Director -01 t'�e I De.)14ient of Transportation to so certify. :: �%• tD 4..J In witness whereof, I have caused my signature and the seal of the Department to be set upon this d cume.., �Iat Ankeny, Iowa this date: http://172.29.254.55/drivers/reports/customerhistoryleertifieddrivingrecord.aspx 12/12/2017 ARTS ........ :oi��,, 12/12/2017 IOWA : a'' D. O.T.;Zi f�( f'UB�VER 4 Office of Driver Services = Iowa Department of Transportation Name: Hamrick, Chadwick Aaron DL/ID: 769YY2955 (IA) O D n -G --I C-3 :� ES_ rn Z� n 0 M Page 2 of 2 a" http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 12/12/2017 A