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Home My WebLink About12-022�r MIM®ill CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa S2240-1826 (319) 3S6-5040 (319) 356-5497 FAX 1. Name Authorization Number /d " as (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) Middle Last 2. Mailing Address AaxCade or j In U &" SL h i / 3. Telephone: Home Other6/tll31�t-976 343> 4. Prior experience in transportation of passengers: )< tar n R C\f P, -Z-Z" W'i hews 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? %)o Type 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? r. ) , Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? tic Type of offense Where When 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? N- Tvpe 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) dant. id,wb.dg 09/2010 I hereby certify that 1 have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number (�� 3 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 Date h****RR111M1f##M######i***#R*M!R*!RM!lNIMMRlR!lRMlf RRlfM1f llf RlMl111Rf*RRl1RRli!llRfRlRlllf MlRlfRRRf*f**1MRlMR*R*MRRlMlflflMf#iff STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by M) c hQt ( oe On this 3/ day of Notary Public in and for the State of Iowa f1M4ffff*fR*RBBB! RR11**t*44f#if41ff4fMMf4lRflMff}1f4f1fMllftffM1fR11ff1f1f}f1f}lfflf**Rf1f*11f}RR}fM*RR*tRRR**RBBB*11RRtMR***fYMtt4lfff 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). I �l✓ Signa ure of Police Chief or designee ign tare of City Clerk or desis� Date -3�- is 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. 4#4##44H##44f1MfM1fMMM1f f #4f4M#4###y,###4##14M#444H##44#fMMf#*4MRf4R4MfMMffMMff4f f ff1Nf iflfMlf f f 1!!111!1 fff lfff f f f########MM Office Use Only Approved application DCI report State certified driving record Website update cleWn dnv adgeaW2010.doc 09/2010 ; C Iowa Department of Transportation Office of Driver Services (Toll Free) OM -532-1121 PO Bot 9204, Des Moines, IA 50306-9204 515-244-9124 1*0 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 12/15/2011 DL/ID #: 15SAC4503(IA) Customer #: 3239199 Name: Hope, Michael Glenn Class: C ID Status: None Address: 69 HOLIDAY LODGE RD Audit #: 3096103 DL Status: VAL Issue Date: 03/10/2009 CDL Status: None City/State: NORTH LIBERTY, IA Expiration Date: 03/06/2014 Restriction None 523179516 Supplement: Endorsements: NONE Mailing Address: 69 HOLIDAY LODGE RD Restrictions: NONE Date of Birth: 3/6/1968 Mailing City/State: NORTH LIBERTY, IA Sex: M 523179516 History Information Convictions Citation Date Conviction Date ACD _ Explanation County JUR ,._—_ 11/01/2008 :12/02/2008 592 Speed 52 -IA Name: Hope, Michael Glenn DL/ID: ISSAC4503 Pursuant to Iowa Code §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 witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: •:;G/84r 12/15/2011 IOWA F �B$�Sr Office of Driver Services �� Iowa Department of Transportation Name: Hope, Michael Glenn DL/ID: 155AC4503 Dec 27. 2011 10:46AM, Div of Criminal Investigation No. 7136 P. 1/2 Dec 1L '. Vwv , enuw gab of lowu amity 319-336-2706 p.2 STATE OF IOWA Criminal History Record Check Request Form Ta: bled Division of Criminal Investigation Sapliali opri:uioas Ihlrcilu, 1" 14um 214 V. 7i0 Street Des Mpines, Imyn '0319 t'1:) 72;_6x66 ON 72.5-60110 Rax 111111 WOULSiint :111 MMI (611 bl:d I livtnrr Rnenrd rhrnt• nn- DCl Account Number: 9 "10 - F (if uyylkoble) 1%ram: l o.✓. CAS bi= 'XQ,,A (—,—Iy Q. v. Rox y18 ehonal 31y 33N - 4'177 7 Nnx: l91 '334-')3s'L 1 aSr Namc unanu:m y First Nnlrlt (m;wJaunl•1 Middle lYa me iheammr,vlea D'1fl` llf lilt rh lnowl.11om) Social Security Number (momm mea) i em .1c ❑Female lVnfPrr lofprnzathn), Without n signed waiver train the snbjm ottht• regacste a complete criminal history record may not i be ralraxnble, per Code of Imus, Chapter 692.2. For eomolet4. trinlbuil history rooard lnfarmetion, ns allowed by law, alwnys obmin a Waivur sl •nnn11'c IYom the .)[Heel of die request. dir :dmtro rrnu: ainp oIC.^,al Ia,x,nauci M Ivwo erm,iuel bilrvq• ream eheel a�itb a,c Divkloa of CYiminel 1Puroer Relvirse, tillPi IA\CL1tIn,iMl 1]X'11 Ah�h•Ililiillt�ia,nH Ja1a [mn nl: F�NIIk111Y NmaWIpN lW lneDt'I 1'Nr bu Nl<uuka aS OIIa1{ed by leW. Iowa Cri Minx! Hktor/Record Cheek Results (DCI vu anly) As of'-- I o1 ' o� , n sciirch ol'thc provided name and daft of birth revealed: 0- No Iowa C riminal I lislor; Record found ivith DCI 1 nL lown Criminal hllsiory Record attached, DCI # Y "I Y S� ! - DO initials,_ t!Vafl(ttr w. -J-77 (08!25/10) Received Time Dec. 15, 2011 4:53PM No.6340 Dec. 27. 2011 10:46AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00494587 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTRD- 2011/12/27 DCI!00494537 NAME! HOPE,MICHARL OLRNN DOB SEX RAC .HGT WGT EYE HAIR SKN POB 196803U6 M W 602 720 BLU BRO FAR IA ADDITIONAL IDENTIFIERS CCN RECORD {'* 01 ARRESTED 19950207 AGENCY. IA0520100 CORALVILLE Pb CHARGE NO- 01 IA STATUTE IA124-401-3 POSSESSION' SCHEDULE I-HARIJUANA TRK91 014615801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEUULB I/MARIJUANA TRK#: 014GIBB01 .SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950707 PROBATION lY 19950707 COMMUNITY SERVICE 100N 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 EUT CAN ONLY BE RELEASED TO NON -LAW EN MENT AGENCIES BY THE OCT. IInNBSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BA INFORMATION FURNISHBD. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No.7136 P. 2/2