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Home My WebLink About18-005r CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. - J (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 Middy y Last - ant e % /'( /4 3. Contact Information (REQUIRED) Email: 4H fb4't& d <O/MCell Phone: (AII written communTEation sent via email) 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) ylel to W Cis 5. Prior experience in transportation of passengers: % yr 0 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this What happened to the charge? (Circle one) nvict Dismissed Deferred Suspended Plead Guilt��y, // Other 7. Have you been arrested / charged with any traffic offenses in the last five years? /fxo Type of offense Where When What happened to the charge? (Circle one) 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 years? /v tZ— Type of offense Where When 9. Have you ever applied to bS 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 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I he74c t I h vg i s to me b the Iowa De rt Int of Trans orta n y�lid Jeri is license number n.L issued on _expiring n — L. G�71 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 provisio �Tyitl�e 5, CJ�ap 2, f the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant l! �� f� Date� N O fffff' -- STATE OF IOWA COUNTY OF JOHNSON N r Subscribed and sworn to before me by ,Ti,myki d. ��s Q on 4� M day of �c ueue� fTZf�18 nm WENDY & MAYE ZB m,.M4r 7294Nota ublic in a for the State of to My mi Du o 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 J&;212c 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. Signbture of City Clerkdesignee Office Use Only Approved application DCI report State certified driving record Website update Date awr✓raxioRNsnocEAPPt92oi4e„boaea.DOC 07/2016 ARTS Pagel of 2 CmJ10WA00T / I SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadotgov Inquiry Date: Customer Name: Address: 1/9/2018 4773745 Shupe, Daniel Ray Office of Driver Services PO Box 9204 I Des Moines. IA 50306-9204 Phone: 515-244-9124 i 86D-532-1121 i Fac: 515-239-1837 www_iowadotgov Certified Abstract of Driving Record DL/ID #: 958AL2175 (IA) CDL Permit Class: None Class: D Audit #: 1533483 1813 LOWR HWY 6 RD Issue Date: 01/06/2017 NW TRLR 81 History Information Sanctions CDL Permit Issue None Date: CDL Permit None Expiration 12/22/2023 f P:.. U '`ems` CDL Permit Date: City/State: OXFORD, IA 523229246 Endorsements: Chauffeur Mailing 1813 LOWR HWY 6 RD Restrictions: Corrective Lenses Address: NW TRLR 81 Restriction None Mailing OXFORD, IA 523229246 Supplement: City/State: ELG Status: Date of 12/22/1956 None Birth: Sex: M History Information Sanctions CDL Permit Issue None Date: CDL Permit None Expiration Date: f P:.. U '`ems` CDL Permit None Endorsements: Iowa Department of Transportation CDL Permit None Restrictions: ID Status: EXP DL Status: VAL CDL Status: None CDL Permit ELG Status: CDL Cert Status: None CDL Med Status: None Type Effective End ACD Explanation IUR Occurrence ]UR Suspended ,02/14/1993 06/19/2015 D53 Non -Payment of Iowa Fine IA Name: Shupe, Daniel Ray DL/ID: 958AL2175 (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: b•'""" •• ;`�15, IOWAfq 1/9/2018 of% D. 0. T a f P:.. U '`ems` �®��1 Office of Driver Services _ ' Iowa Department of Transportation http://172.29.254.55/drivers/reports/oustomerhistory/certifieddrivingrecord.asi)x 1/9/2018 Fdanu.U. 8;51AM Div of Criminal Investigation No. 0502 P. 1/7 .mvi,. .n iuwr 4.ny Cl elw vui0o a,n upp buv/ 01/00/20 B 'I ' 1 2:68 0338 P•002/002 STATE OF IOWA — q4 1 'iw'• Request t To: Iowa Divisloe of Criminal Investigation Support Operaiions Bureau,l°' Floor MS E. 71h Street Des Moines, Iowa 50319 (515) 725.6066 (515) 725.6080 Fox 1XIAccount Number; _— (;raPsa�eel�) From:Cil ntlolva CI City Cleric's o10oe 410 E. Washinglon Street Iowa City, IA $2240 Phone; 319-356-5041 Fax: 319-356-5497 As of a search of the Provided name and date of birth revealed: 13 No Iowa Criminal History Record found with DCI Iowa Criminal history Record attached, DCI # DCI initials—c-n-1— DCI -77 (08/25/10) Received Time Jan, 9, 2018 11:30AM No. 2560 (DCluse only) R V'q !r•, I 1''1 � X11 11so CD a cn Jan -10. 2018 8:58AM Div of Criminal Investigation DCI:00261161 . NAME: SHUPE,DAN SHUPE,DAN M SHUPE,DAN R SHUPE,DAN RAY SHUPE,DANIEL RAY DOB SEX RAC 19561222 M W ADDITIONAL IDENTIFIERS SC L HND IOWA CRIMINAL HISTORY FELONY CONVICTION DCI 00261161 PAGE 1 OF 6 DATE PRINTED - 2018/01/10 HGT WGT EYE HAIR SKN POB 509 185 BRO BRO MEP IA CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19500110 AGENCY: IA0940100 FORT DODGE PD CHARGE NO- 01 IA STATUTE IA716-5 CRIM MISCH 3RD DEGREE TRK#; L17418901 COURT DISPOSITION AGENCY: IA094015J WEBSTER CO DIST COURT COUNT NO- 01 IA STATUTE: IA715-5 CRIM MISCH 3RD DEG CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17418901 SENTENCE PROBATION lY SUSPENDED 901) 02 ARRESTED/TAKEN INTO CUSTODY 19871121 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA204-401 POSS COCAINE TRK#: L17419001 CHARGE NO- 02 IA STATUTE IA123-46 PUBLIC INTO% TRK#: L17419002 COURT DISPOSITION AGENCY: IAO52015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401 POSSESSION-SCH II -COCAINE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419001 SENTENCE FINE $250 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA123-46 PUBLIC INTOX CHARGE CLASS; MISDEMEANOR CONVICTION DISP EFF DAT 19800317 19800317 DISP EFF DAT 19850331 No. 0502 P. 2/1 J4n,10. 2018 8:58AM Div of Criminal Investigation TRK#: L17419002 SENTENCE PLEAD GUILTY FINE $50 03 ARRESTED/TAKEN INTO CUSTODY 19980115 AGENCY: IA0460000 IOWA CO SO CHARGE NO- 01 IA STATUTE IA908-11 PROS REVOCATION TRK#: L17419101 COURT DISPOSITION AGENCY: IA0480153 IOWA CO DIST COURT COUNT NO- 01 IA STATUTE: IA908-11 PROB REVOCATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419101 SENTENCE JAIL SOD REVOKED 04 ARRESTED/TAKEN INTO CUSTODY 19890909 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- OS IA STATUTE IA123-46 PUB INTOX TRK#: L17419201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123-46 PUB INTOX CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419201 SENTENCE PLEAD GUILTY PAY SURCHG FINE $25 COURT COSTS 05 ARRESTED/TAKEN INTO CUSTODY 19891026 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND TRK#: L17419301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 owl 2ND CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419301 DCI 00261161 PAGE 2 OF 6 DISP EFF DAT 19880405 19880405 DISP EFF DAT 19900201 19900201 19900201 No, 0502 P. 3/1 Jan.10. 2018 8:58AM Div of Criminal Investigation DCI 00261161 PAGE 3 OF 6 SENTENCE DISP EFF DAT JAIL 7D 19900112 FINE $750 19900112 PROBATION 2Y 19900112 SUSPENDED 23313 19900112 CREDIT W/TIME SERVED 7R CR;SAE/TRMT;PD 19900112 SURCHG;022692 PROS VIOL - 233D 06 ARRESTED/TAKEN INTO CUSTODY 19920208 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 3RD OFFENSE TRK#: L17419401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI 3RD CHARGE CLASS: FELONY CONVICTION TRK#: L17419401 SENTENCE DISP EFF DAT JAIL SY 19920414 PAY SURCHG FINE $750 19920414 07 RECEIVED 19920511 AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA321J-2-C OWI 3RD TRK#: L17419501 (OWI HOUSING) INMATE #: 026564 CHARGE NO- 02 IA STATUTE IA321J-2-B OWI 2ND TRK#: 1,17419502 COURT DISPO92TION AGENCY; YA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2-C OWI 3RD CHARGE CLASS: FELONY CONVICTION TRX#: 1,17419501 SENTENCE DISP EBF DAT JAIL 5Y 19920511 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA321J-2-B OWI 2ND CHARGE CLASS: MISDEMEANOR CONVICTION No, 0502 P. 4/7 Ja.n, 10, 2018 6:59AM Div of Criminal Investigation No, 0502 P. 5/7 TRK#: L17419502 SENTENCE JAIL CONCURRENT COURT DISPOSITION AGENCY: IA016019J COUNT NO- 03 PCI 00261161 PAGE 4 OF 6 DISP EFF DAT 2330 19920511 W/CT 01;SENTENCE DISCHARGED 19920511 CEDAR CO DIST COURT IA STATUTE: IA321J-2-C OWI 3RD CHARGE CLASS: FELONY CONVICTION TRKO: L17419503 SENTENCE CONSECUTIVE SENTENCE W/CT 01 JAIL 5Y CUSTODY AGENCY: IA077015G ADULT PAROLE SVC A 19921109 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC B 19940506 PAROLE REVOKED CUSTODY AGENCY: IA077015C ADULT PAROLE SVC C 19950105 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC D 19950901 PAROLE REVOKED VIOL PROG ADMIT CUSTODY AGENCY: IA077015G ADULT PAROLE SVC E 19951107 PAROLED VIOL FROG CUSTODY AGENCY: IA052015M OAKDALE IMCC F 19960509 PAROLE REVOKED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC G 19970124 PAROLED CUSTODY AGENCY: IADE2015M OAKDALE IMCC H 19970509 PAROLE REVOKED FOLLOWING FINAL REVIEW HEARING CUSTODY AGENCY: IA077015G ADULT PAROLE SVC I 19970714 PAROLED W/IMMEDIATE DISCHARGE 00 ARRESTED/TAKEN INTO CUSTODY 19940127 AGENCY: IA0160000 CEDAR CO SO DISP EFF DAT 19940506 19940506 Jan.10. 2018 8:59AM Div of Criminal Investigation DCI 00261161 PAGE 5 OF 6 CHARGE NO- 01 IA STATUTE IA321J-2 OWI -3RD TRK#: 004722201 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 01 IA STATUTE; IA321J-2 OWI 3RD CHARGE CLASS: FELONY CONVICTION TRK#: 004722201 SENTENCE DISP EFF DAT PLEAD GUILTY 19940506 JAIL 5Y 19940506 COURT COSTS 19940506 09 ARRESTED/TAKEN INTO CUSTODY 19960103 AGENCY: IA0520100 CORALVILL£ PD CHARGE NO- 01 IA STATUTE IA124-4D1(3) POSSESSION-SCH II -COCAINE TRK#: 013266201 COURT DISPOSITION AGENCY: lA0S2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124-401-3 POSSESSION SCH TI -METHAMPHETAMINE COURT CASE ID: 06521 SRCR040176 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; 013266201 SENTENCE DISP EFF DAT JAIL BOD 19960408 FINE $250 199604DB 10 ARRESTED/TAKEN INTO CUSTODY 20000906 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA714-1-1 THEFT 2ND TRK#: 100010901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: XA714.2(2) THEFT 2ND DEGREE - 1978 COURT CASE ID; 06521 FECR055571 CHARGE CLASS: FELONY CONVICTION TRK#: 100010901 RESTITUTION SENTENCE DISP EFF DAT TIME SERVED 24D 20040806 FINE $750 20040806 SUSPENDED PRISON 5Y 20040806 PROBATION 5Y 20040806 No.0502 P. 6/7 Jan. 10. 2018 8;59AM Div of Criminal Investigation No. 0502 P. 7/7 PRXSON SY DCI 00261161 PAGE 6 OF 6 20040006 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTXOATION, 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 INOUIRY. DIVISION OF CRIMINAL INVESTIGATION CCS