The URL can be used to link to this page

Home My WebLink About18-010CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 5 2240-1 82 6 (3 19) 3S6-5040 (319) 3S6-5497 FAX 1. Name (REQUIRED) _ IDENTIFICATION NO. (g— 0 1O (Office Use Only) APPLICATION FOR TAXICAB I 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 Last 2 _o 2. Address (REQUIRED) kCj 2`3 -^ -C �7 t r no ^ 2� Se 3. Contact Information (REQUIRED) Email: 90-rN S' r e_tz2• ti�a esu ,, t Cell Phone: 3 4 S o -i 2 22- (AII written communication sent vi email) -i 4a. Driver's License expiration date (REQUIRED) 631/3) b. Taxicab Business Name (REQUIRED) W \ ( rt u C- ti 5. Prior experience in transportation of passengers: C i ca 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Tvoe of offense nwl W here -0nV%%vn When What happened to the charge? (Circle one) Convicted Dismissed Deferr Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where n When What happened to the charge? (Circle one) CConvict9�) 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 VIf \� - A-vV. -\ -r ed L� C 7- 9. Have you ever applied to be 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 r APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 hereby certify that.1 have issued to me by the Iowa Department of Transportation a valid Driver's license number Q 2 1 ?'Z_ 4 2 -1 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 provisio of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applican�t sz) v Date ` z N Ca W 5�C7 f111111tf1fllfYf-f1fYf11ff1fllf HYffllllNlM STATE OF IOWA COUNTY OF JOHNSON ) zl r >• M Subscribed and sworn to before me by r�a.�r;\� �. 1�c�gL+2� ois"this'aT l� day of 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,do v nsex/31 120 Z I Z6,/Z G/ S' " ure 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. ecC<e /-21 -/� Signature of City Clerk or6bsignee / 1 Date Office Use Only Approved application DCI report State certified driving record Website update aerk/TAXIDRNBADCEAPPL92014am ded.DDC 07/2016 o7Jan.23. 20 1 8:c 8:58AM CabDiv of Criminal Investigation (FAX)3193382No. 1501 P. 1/4„003 'TATE OV XOWA Criminal History Record Check (0 1 & Request Vorm Tar Iowa Division of Criminal Investlgatlon Support Oparatlons Bureau, P' Floor 215 E. 7"' Street r Des Molnes;lowa 50319 (515) 725.6066 , (518)725.6080,Fax ^ ----- n,..-,. DClA000untNumber:`9967-F - (lreppllolbie) Fromi Yellow Cab of Iowa City P.O. Boz 428 Iowa City, IA. 32244 (319) 338.9777 Phonon FOxr (319)339-7302 1 n,a iG U95t iiM w„ 1VnY vuuuuw, •amw•x est Name mendn —.••.•••.• �•.��.. �... ]First Name mtndele Midd18N Me(mommeodad)' ik C e 0.�S1G2— Dato of Birth (mendete (;eudar meodolc SoQial•Sccurl Plumber reeommenda 3 f Male OFemale 3i CJ ^ to a ^ Waiver Information.- Without a signed waiver from the subject of the regµost, a compigto criminal history record may no be releasabie, per Colic of Iowa, Chapter 692,2, For pgrgolattt criminal history -record Information, w allowed by law, always obtain s WAIVOr allinature from the subject of the re ues , WetiverRelease:Ihereby give pernlltrlon(0tgeslingoftlaltoeonpuelanIOWA Driminelhlnorywcsrdcheckwtlhthe DivlslonofCrimind • e reloued AS Alloway by low. invetllgellon (Ddl). My orlmind history dsts coneTmvlruvlM*bylhr0 Waiver 91grzafure Iowa Criminal History Record �,ll,eck Reslllts (DO[me Only) As of 2 3 g a search of the provided name and date of birth rovoaled: ❑ No Iowa Criminal History Record found with DCT c ., DCI # Iowa Criminal History Record attaehod, N 5Jh� ACI initiu19 DC147 (08/25110) Received Time Jan. 22. 208 10:20AM No, 3153 ,Jan.23. 2018 8:58AM Div of Criminal Investigation No.1507 P. 2/4 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00762862 NAME: RABBED, PATRICK RADCLIFF RABHED,PATRICK RADCLIFFE DOB SEX RAC HOT WOT EYE 19670331 M B 507 190 BRO DCI 00762662 PAGE 1 OF 2 DATE PRINTED - 2018/01/23 HAIR SRN POB BLK ELK YY ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20051101 AGENCY: lAOS20200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA32IJ-2 Owl TRK#: 101695601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(A) OPER VEH WH INT (OWI) / IST OFFENSE COURT CASE ID: 06521 OWCRO74189 CHARGE CLASS: NON CONVICTION TRK#: 101695601 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT PROBATION 365D DISCHARGED FROM DEFERRED JUDGEMENT 02 ARRESTED/TAKEN INTO CUSTODY 20060416 AGENCY: IA0570300 CEDAR RAPIDS PD CHARGE NO- 01 IA STATUTE IA321J.21 DRIVING WHILE REVOKED TRK#e 503541301 COURT DISPOSITION AGENCY: IA057015J LINN CO DIST COURT COUNT NO— 01 IA STATUTE: IA321A.32 OPERATING VSH/W LICENSE SUSPENDED /FINANCIAL COURT CASE ID: 06571 SRCRO66578 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 503541301 SENTENCE TIME SERVED FINE $250 JAIL 2D 03 ARRESTED/TAKEN INTO CUSTODY 20091010 AGENCY: IA0570100 CEDAR RAPIDS PD CHARGE NO— 01 IA STATUTE IA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER — 1978 DISP EPP DAT APPEAL DATE 20051208 20060701 20051208 20060829 DISP EPP DAT 20060503 20060503 20060623 Jan. 23. 2018 8:58AM Div of Criminal Investigation No. 1501 P. 3/4 TRK#: 5A007PN01 COURT DISPOSITION AGENCY: IA057015J COUNT NO- 01 LINN CO DIST COURT IA STATUTE: IA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06571 AGCR085372 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 5A007PN0I SENTENCE TIME SERVED JAIL 2D FINE $625 04 ARRESTED/TAKEN INTO CUSTODY 20110721 AGENCY: IA0570000 LINN CO SO CHARGE NO- 01 IA STATUTE IA714.10 FRAUDULENT PRACTICE 2ND DEGREE - 1978 TRK#: 5AOOE4R01 COURT DISPOSITION AGENCY: IA057015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE: IA714,11(1) DCI 00762862 PAGE 2 OF 2 DISP EFF DAT 20100216 20100216 20100216 FRAUDULENT PRACTICE THIRD DEGREE--$500-UNDER $1000 COURT CASE ID: 06571 FECR094707 CHARGE CLASS: NON CONVICTION TRK#: 5AOOE4R01 ' RESTITUTION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20111209 PROBATION 2Y 20111209 DISCHARGED FROM 20131217 DEFERRED JUDGEMENT 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 POR POSITIVE IDRNTIPICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. V DIVISION OF CRIMINAL INVESTIGATION Iowa Department of Transportation 1! 0 , DMCC of Drrvu Sernces (Toll Free) NO -532-1121 POBox 9204, Des Manes. IA 50308-9204 515-244.5124 FAX 515-239.1831 Certified Abstract of Driving Record Inquiry Date: 1/19/2018 DL/ID #: 821ZZ8427 (IA) Customer #: 4009739 Name: Rashed Patrick Class: D ID Status: None Radcliffe Address: 1923 MOUNT Audit #: 1519172 DL Status: VAL VERNON RD SE Issue Date: 12/29/2016 CDL Status: None City/State: CEDAR RAPIDS, IA Expiration Date: 03/31/2021 CDL Cert Status: None 524033326 Endorsements: Chauffeur 2 CDL Med Status: None Mailing Address: 1923 MOUNT Restrictions: Corrective Lenses Restriction None VERNON RD SE Supplement: Date of Birth: 03/31/1967 Mailing CEDAR RAPIDS, IA Sex: M City/State: 524033326 History Information Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date I Case Number 3UR 12 30 2013 776557 IA Name: Rashed, Patrick Radcliffe DL/ID: 821ZZ8427 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: 1/19/2018 IOWA %w D.0.T.c�s ➢ Office of Driver Services I'°" Iowa Department of Transporation