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Home My WebLink About18-011CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 5 2240-1 826 (319) 356-5040 (319)356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO._ (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 4v) i Last 3. Contact Information (REQUIRED) Email IM &Gal C cm i Cell Phone: (All written coma unica ' n sent via email) 4a. Driver's License expiration date (REQI b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa Ct --cI 3 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense VIC Where TGw�(I When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other Have you been arrested / charged with any traffic o arises in the last five years? ." Yos Twe of offense 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? 8040j 40j Type of offense Where When 9. Have you ever applied to bean Iowa City taxi driver using a different name? If yes, please prok�de the4me(s) hh DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAT ti:ERT D DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE Q#IIEF RE IEW� -b { You must apply for an individual Department of Criminal Investigation Report (form av�lsf, uRon re qu tt). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) —i 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 -51 L-14— of 4 0?i issued on wexpiring on 3 ) . I understand that if 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 Date 1Yftf1f11fif4f 1fHH1HHfHHHH11HHH1H1N1f f ff f f f 111ff1ffN}f4ft4H44fHffHHlfHffff f 11f11fflHHf STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by �-lr� (�� , l-} Q on this — day of S.MAYER In 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 0310 Gb p/ q -�7 01/zlc/761� nature 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. / - -;Z &-/r Signature of City Cle or designee 944f4H1ff tiY#1H1H1H1fHfff fflfHlffYfllfff f fnffffflf4flf 4ye�ff1fY'f11'ffiY11H1141fe441H1Hf1fff4HH1ffM1fff11Rtefffflfflflt}1HlefefllH'1#1f414 Office Use Only N O Approved application o a_ccl) m DCI report D:::; ZEE State certified driving record < N Website update+C r <m M aen✓rauoarvanoceAPPL9201�.DOC 07/2016 f pjVAM 2VdN3W--i♦YAA .w`c:i �BSW:s .,,OmuK rauam�� 1 �s, l��fff Iowa Department of Transportation 0(1)ce d Dlivar Services (Tdl Free) 600-&V-1121 po gar 9204, On MMM, Ut 503069204 515-2"-9124 FAX: 515-231-1637 Convictions Citation Date Certified Abstract of Driving Record ACD Inquiry Date: 1/8/2018 DL/ID #: 155AC4503(IA) Customer #: 3239199 Name: Hope, Michael Glenn Class: D ID Status: None Address: 459 S SCOTT BLVD Audit #: 1350116 DL Status: VAL Fail to Obey Traffic Issue Date: 10/07/2016 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 03/06/2019 CDL Cert Status: None 522455527 06/28/2016 Improper Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 459 S SCOTT BLVD Restrictions: Corrective Lenses SRestriction upplem ent: None Date of Birth: 03/06/1968 Mailing IOWA CITY, IA Sex: M City/State: 522455527 History Information Convictions Citation Date Conviction Date ACD Ex lanation Count Occurrtc� R 03/28 2013 05/12/2013 S92 Seed Johnson lUR 12/15/2013 02/03/2014 M14 Fail to Obey Traffic Johnson "IA Si n Si nal Iowa Fine 05/26/2016 06/28/2016 Improper Johnson Re istration Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Sanctions Iv Type Effective End ACD Explanation Occurrtc� R lUR Suspended 10/05/2016 10/06/2016 D53 Nor -Payment of IA C -)—C Iowa Fine Name: Hope, Michael Glenn DL/ID: 155AC4503 71 —D I If N _ter Pursuant to Iowa Code 4321.10, I, Melissa Spiegel, Director of Office of Drivgr 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: 1/8/2018 Q. 0. T. office of Driver Services Iowa Department of Transporation Name: Hope, Michael Glenn DL/ID: 155AC4503 N (] � _O m L C') -G N C, �C-) ;lr- M v M Co -� � a N 0 •oiJan, 9. 2018:: 9:12AK catDiv of Criminal Investigation (FAX)31933s• L 0366 P., 1/22/002 STATE OF IOWA Criminal History Record Check, Request Form 0 DCI Account Number: 9967-F (Irappllcable) To$ lows Division of Criminal investigation Support Operations Bureau, 1"Floor 219 E. 714 Street Des Moines, Iowa 50319 (515)725.6066 (515)725.6080 Fax 1 am reciuestina on Iowa Criminal History Reenrd Cheek nn - From: Yellow Cob of Iowa City PA Box 428 Iowa City, IA. 52244 (319) 338-9777 Phone) Fax: (319) 339-7302 Mast Name (mandato .First Name mendalo Middle Nome (,,eomm, dqd f_ Date of Birt/hlmandmo) Gendeerrmendato So clal-l-$aourl Number (reeommandad 340 ILIMnle ❑Female r v1v Waiver Information: Without a signed waiver from the subject of the request, a complgto grlminal history record may not be releasable, per Cado of Iowa, Chapter 692.2, For comolain oriminel history rocord Information, es allowed by law, always obtnln a waiver signature from the subject of the request. Waiver Re%ease: I hereby viva pormladon rot Iia aboveruqualting olnelsl io candw an Iowa criminal bbloryraeurd oheek with IN Division ofUminel Invenlgatlon (DCO, Any crlminel history dela concem'N me that is melnlalned by the DCI may be released as allowed by law. Walviy signahlre: Iowa Criminal History Record Check Results A9 of 1- I IL , a search of the provided name and dote of birth El No Iowa Criminal History Record found with DCI Y� —Iowa Criminal History Reoord attached, DCI DO inittali`L. _ DCI -77 (08125/10) Received Time Jan, 8. 2018 1:45PM No. 2503 (DCI see only) f_ to I r v1v t } 1..J . r_ cil—n rri N Jan. 9. 2018 9:12AM Div of Criminal Investigation No.0366 P. 2/2 IOWA CRIMINAL HISTORY DCI 00494587 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED - 2015/01/09 DCI:00494587 NAME! HOPE,MICHAEL GLENN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19680306 M W 602 320 BLU BRO FAR IA ADDITIONAL IDENTIFIERS CCH RECORD •x+ 01 ARRESTED/TAKEN INTO CUSTODY 19950207 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401-3 POSSESSION SCHEDULE I -MARIJUANA TRK#: 014615801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT 140- 01 IA STATUTE: IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA TRK#: 014615801 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950707 PROBATION lY 19950707 COMMUNITY SERVICE 100H 19950707 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 PCS. 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 INQUIRY. DIVISION OF CRIMINAL. INVESTIGATION N O CC'� m C") C-) �n N CA rn a CC'�