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Home My WebLink About12-013First Middle Last 1. Name A KL 5 Mju4AL-1_ cok ueu 4✓ 2. Mailing Address 15a746-erAVC l4% To" CL�,'LIj 512Y1 3. Telephone: Home �11) IA; 7)Y6 Other: 4. Prior experience in transportation of passengers: _ .4o5- R 3 04Lo gorivc V 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? A0 TVpe of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? V \O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? t1b Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? X10 TVDe of offense Where When 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) The re- port will be mailed to the individual making the request and needs to be reviewed by the Police Chief with this appli- cation. (OVER FOR REQUIRED SIGNATURE AND NOTARY) clerW idnvbadg 09/2010 Authorization Number /a -).S l 1 (Office Use Only) CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington street between 8 a.m. to 3 p.m., Monday— Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 3S6-5497 FAX First Middle Last 1. Name A KL 5 Mju4AL-1_ cok ueu 4✓ 2. Mailing Address 15a746-erAVC l4% To" CL�,'LIj 512Y1 3. Telephone: Home �11) IA; 7)Y6 Other: 4. Prior experience in transportation of passengers: _ .4o5- R 3 04Lo gorivc V 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? A0 TVpe of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? V \O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? t1b Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? X10 TVDe of offense Where When 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) The re- port will be mailed to the individual making the request and needs to be reviewed by the Police Chief with this appli- cation. (OVER FOR REQUIRED SIGNATURE AND NOTARY) clerW idnvbadg 09/2010 ft I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number <t 1 1%j c2 g I understand that if I falsely answer any questions in this application, that this application may be denied. I understand that if I falsely answer any of the questions in this application, that this application will 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 a license 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 /rt Date ( (, 020 2 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by Jr. Oyt I ly K,7 LVX On this day of a — SONDRAE FORT commission t Number 5BT81 U. rnmrn;eum r 159. Notary Public in and for the State of Iowa Rf##Y#fY*lf4lff*ff*hRf*RR*R***R*RtRRRRIR*RR*RBBB*RR*R*R*tf*hR*4Y*f444#44#f44#t*f#Y#444##f#***#t*R******!R*f*RRf41RNf44f444###!44!!41!#!####44## I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). Date Date After Police Chief and City Clerk have approved authorized taxi driver names will be placed on the city website at icgov.org. Taxi cab businesses are required to provide Driver Identification cards. fi+ffffl+f1+111+111+1fY144ff4+4444441444444N44;444444444;444Y#41444+1111f11+11+f1f+++++1111+f1f1#'flff*tH*;;41441-;#1e44;4;f444444i#4R;;4H;;444; Office Use Only Approved application DCI report State certified driving record Website update deYJ dnvbadgeap,2010 doc 09/2010 J Iowa Department of Transportation Office of Driver Services (Toll Free) WU-532-1121 PO Box 9234, Des Moines, IA 50306-92124 515-244-9124 FAX: 515-239-1837 Inquiry Date: 1/6/2012 Name: Calloway, James Michael Address: 1527 ABER AVE APT 6 City/State: IOWA CITY, IA 522464704 Mailing Address: 1527 ABER AVE APT 6 Mailing City/State: IOWA CITY, IA 522464704 Certified Abstract of Driving Record DL/ID #: 302BB2358(IA) Class: B Audit #: 4986660 Issue Date: 02/03/2011 Expiration Date: 01/20/2016 Endorsements: NONE Restrictions: NONE Date of Birth: 1/20/1968 Sex: M History Information CLEAR DRIVING RECORD Name: Calloway, James Michael DL/ID: 302BB2858 Customer #: 1808601 ID Status: None DL Status: VAL CDL Status: VAL CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Pursuant to Iowa Cade §321.10, I, Kim Snook, 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 wltness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: '•:�/ �4 1/6/2012 IOWA'y' =44V ). 0. T. -.44 ID.... S Office of Drover Services aL878D Iowa Department of Transportation Name: Calloway, lames Michael DL/ID: 302BB2858 . . 16__20111�3;16PM v J Div of Criminal Investigation DCI 10h.3656 P. 9/10�olGo G(D r STATF OF IOWA Criminal History Record Check Request Form To: fowa))IVLII NofCriminalloveatt OON Support Operattom 11""t , l' Floor 215 F. 7a' Street Des Molnb, to*% 50319 (515) 775-6066 (515)775.6080 Fax DClAccountNumber: ? ptepoia,ble) From) 1MarGr5 74x1 a Phone[ Fen LaatN■me FI Lt NAme (radnow Oddic Name C% LLOCO&Y 31�w�eS yvQu{�G� Date of Birth b!RatM Geader naadw sMMft Number eoomwmaea l r& 13'tir�e OFemale�2 7aaa I' �olverlafdrrnm%nnf Without it Biped welver from the subject of the regeert, a complete criminal history record may not be raleaablo, per Code of fawn, Chapter 692.2, For yplpglftti sdartad bbtory record Woteudo■, as allowed by law, dwaya o laaWAVera alum from the sabretofthe MgUA W9jverReleaKItarey81rrceWillow rw tmerOpeon(OM. AvyaDOWWtwydaa ftawvDT9* 49MrWtoro:d(crmlawsMA lhWMwontrb&kwMdieD(vWBnorgiznDW io v*6MYnrhdrkej4o may le rclaued u elbaed M low. WaiverSlgndlrwe: (nc[um Wy)- A0 of 10 — / 6—1 +_ . a search ofthe provided nardo and dote ofbirth revealed: 0 L"` No Idw4 Criminal History Record found with DCi , ❑ Iowa Climb d iTistory Record anuched, DCC N DCj initials Received Time Dec, 9. 2011 12:09PM No, 5802