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Home My WebLink About18-0136. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Where What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty 7. Have you been arrested / charged with any traffic offenses in the last five years? Where kl'Q When Other 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? Type of offense Where When 9. Have you evIr applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) L 0 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 77 IDENTIFICATION NO. (�—O 11-3l (Office Use Only) FILE® •.rt,�,._ JAN 2 9 2010 APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police DeiiAV nI%e6Weview must be made between 8 a.m. to 3 p.m., Monday— Friday) 410 East Washington Street IOWA City, IOWA 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 t iddllL�s1 1. Name (REQUIRED) VI 1 S� 2. Address (REQUIRED) l 2 r2 3. Contact Information (REQU Cell Phone: -?N / (AII wri n 4mmunic#tion sent via email) ) 4a. Driver's License expiration date (REQUIRED) AI/7 b. Taxicab Business Name (REQUIRED)(�'� 5. Prior experience in transportation of passengers: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Where What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty 7. Have you been arrested / charged with any traffic offenses in the last five years? Where kl'Q When Other 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? Type of offense Where When 9. Have you evIr applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) L 0 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 77 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I here rt' t t 1 ve issued to me by the Iowa D p rtment of Transport o a v� id Driver's license number L �J% issued on ((expiring on .�,�. 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 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 1/1 51/t Date(]/ 2— FILED E JAN 292018 1H!llifiliYY{***Yt*f*!!flllfl!!lfflii#}i##{'Ff.'#**#{**!**lH144#fi#4****{{*-ifllf!!i#!#144Y#Y#i#YY**{#flllflffYliiiYY##Y**Yti**1111fi#i#*Y# STATE OF IOWA )`ItY {Clerk COUNTY OF JOHNSON ) Iowa City, Iowa Subscribed and sworn to before me by on this a5` day of in and for themeof Iowa *********Y{*,y{{i{*f(lfeik**i*fek*fe*fie*i*###i***{,F**,FR1(kf(fe*fefrtfeirt*****{****y,{,*{**G{,{*{**tfe**tG*,F#**#***##*#*{*ieie****#+**{{**Y#*##hfi#•f#effffffff*{*{* 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 I I /'?4 2 Z Z Signature of Police Chief or designee 11 Dated 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. ` Si ature of City Clerk or designee /—a9 -iy/ Date #i##YN,1fllf11f1f1f11fffYlitif#!}iiY{iY##'i*fliflllflfllllfiif####Yi##Y#{###Y*f*f!*f!!1f!!11#fi##ie#*Yi,ii#Y{!{11flN#lfiiii#fi#lYHii##k;ffl,lf„ Office Use Only Approved application DCI report State certified driving record Website update CIeA/rAXIDRN64DGEAPPL92014amended.DDC 07/2016 F. -VOW QJ10WADOT JAN 29 Y01B SMARTER I SIMPLER I CUSTOMER DRIVEN WWWJ0W� otic` aX'r Office of 6r-oids6ljom PO Box 9204 1 Des Moines. IA 503D6-9204 Phone: 515-244-91241800-532-11211 Fax: 515-239-1837 www.iowadot.gov Inquiry Date: 1/17/2018 Customer #: 4292418 Name: Allison, Kevan Michael Address: 621 1/2 BROWN City/State: IOWA CITY, IA 52245 Mailing 621 1/2 BROWN Address: D Mailing IOWA CITY, IA 52245 City/State: Date of 11/29/1961 Birth: 9136520 Sex: M Convictions Certified Abstract of Driving Record DL/ID #: 769YY0847 (IA) CDL Permit Class: None Class: D CDL Permit Issue None BYryEi Date: Iowa Department of Transportation Audit #: 9136520 CDL Permit None Expiration Date: Issue Date: 06/03/2015 CDL Permit None Endorsements: Expiration 11/29/2022 CDL Permit None Date: Restrictions: Endorsements: Chauffeur 3 ID Status: None Restrictions: NONE OL Status: VAL Restriction None CDL Status: None Supplement: CDL Permit Status: ELG History Information CDL Cert Status: None CDL Med Status: None Page 1 of 1 :Itation Date Conviction Date ACD Explanation JUR County 1.1/14/2015 02/11/2016 592 Speed IA Johnson Name: Allison, Kevan Mlchael DL/ID: 769YY0847 (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 custodlan 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: Name: Allison, Kevan Michael DL/ID: 769YY0847 (IA) 1/17/2018 r,t0,: •.`": IOWA ..... 1/17/2018 .D. tci`}Office of Driver Services BYryEi Iowa Department of Transportation Name: Allison, Kevan Michael DL/ID: 769YY0847 (IA) 1/17/2018 F,Jan. 19. 2018, 1:22PM�..,Div of Criminal Investigation 6.3No.1266,,,P... 3/341OO2 STATE OF IOWA Criminal history Record Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, 1" Floor 215 E. 70i Sh•cet Des Moines, Iowa 50319 (SIS) 725-6066 (515) 725-6090 Fax f am requesting an aa�I st Name (mond /-( � S 41 Criminal History Record Check on: FILE® DCI Account Number: (if applicable) From:City of fovea Clly Cily Cla k's OfGce� 410 E. Washington Street Kowa City, IA $2240 Phone: 319-356.5041 Fax; 319.356-5497 Basle OFemale vrarvertnjormntfon: Without s 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 complete criminal history record Information, as allowed bylaw, always obtain a waiver signs lure from The subiect of the rn9me6t Wailser Release, Ihereby sive permission for the above IN"ins olTiclal (o conduct an lover criminal history record check with the Division ofCrlminal invalization (DCO. Any criminal history 6916 wrncemine me (hat Is maintained by the DO may be released as all9we4 by law, Waiver Signature: (DC) use only) As of 1 M M , a search of the provided name and date of birth revealed: No Iowa Criminal history Record found with ACI e_ ® Iowa Criminal History Record attached, DCI cu ;u DCI initials -U DCI -77 (06/25/10) tai Received Time Jan. 18. 2018 2:04PM No.3044