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Home My WebLink About12-026�r 1III 54 CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1821I6 (31 9)5040 rA0 P I 6k � Q 19) 356-5497 FAX 1. Name 2. Mailing Authorization Number 1a-16 (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 3. Telephone: Home 31 c1- G 2. /— Z).^l p (�- Other: 4. Prior experience in transportation of passengers: Oo f 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ' ! c fo /tN F taia d� Tvoe of offense Where When L. cc.>un }o ',ra'VUiui vi; ckLt'�) f n •, ct vtFcn{ivc r Oii'an 6. Have yon convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? ,P0 Type of offense Where When 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? Tvoe of offense Where When 9. Have you ever applied to bean 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) der .,dnWadg 09/2010 I here cTfy th t I have sued to me by the Iowa Department of Transportation a valid Chauffeur's license number �I Z �i $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 Date +##lHH++#++H#RRlRf !HHRH++HR++4+F#fHtflflHHfffifflHY!!llfHfllHHHfHYflHYHH##HYHH#Y#f##f+++1+++*HHH+i+#+#++*H1fHl1HH1Y STATE OF IOWA ) COUNTYOFJOHNSON ) scribed and sworn to before me by i%. F I s+, On this 8 day of ort SONDRAEFORT Commission Number 1597gt 3M om lesion EWret Notary Public in and for the State of Iowa *%f*%**%**it444}H44}R}%***R*%titit*tt*4144111444114l41111H#1R*RRtRRRRR}RRfR*3f*%RR**HR***4H*H31t*tt*H**tti*ti}t4444i###*Hit}H44444R44tR} 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. #1111 f fYHHfHHf+++#++ff *1ffMlHHifH+f({H*HRf*%f1f 11ffHf111H1Hf HHHN11f11f11f 1141 f lHfllffff+#fi#1fHH-*11144#f+}H4*tflff*ft11HHf Office Use Only Approved application DCI report State certified driving record Website update CledJlazidmbadgeaWN10 d 09/2010 JdJ1.)I. LU12 111::I:)h11 61iyoV,lerKm- L,IIlyoo1s10WatiIIy No.2885 P. 6/9 No. Mi r. Y/2 U b' STATE (OF X(0)WA d l.i •L�•. z CrAminal.alstory: \ e 1 I /:Check��Sl (nfnlf ii •�' r :. d Vii:<• v Sp'- To To: YOwaYlfvlslon0PCthninaIYhypsirgation Support Operations>aut/oaa,1''Taor 215 D. 7'h Sireot ))o3Mo1ans,7o)VA 50919 (515) -72649d6 (515)125-6090 pAk S+on Cheok on: fL 7 1)C1 rlccoi)at11Umber.. ''((ii aD��DUceDfa) Arm! CITY 01? -1= CITY CITY CLEPZYS 0 nex IObTA CITY n47A „$2240 k�tonA; 419-4SE—Sn4] —�— �. 1 � TT' *are ' Eireznare . ``1 Tc, ^.nl -z c% qO naii'dY VOY'Matioly"WithoutA61knodWREvorthomthesubledOfffiorogaeah,aeomprotacrfnfnAlhtsfolyraeordwmyliot Aeyolpasn61�pe1�CadooliXawp,C]i0ptor69z.allorcom fp^ara.-crinilaalhistotyt'Aoordinfofcrnnt(on,Asnllowed6ylovirp(frups T�lDt'YBY eiedSEiTIcrcLY$ivePermlgfontlrlTopDoY6rAgleslingOfflcipffo ndv unLownorlmtndhlsloyeeeordcheck *11hlheDivinfanpjCrinirnol Ynrwllgellon(DCh, Anycrintfnslhfslorydalpc0� "ntltinalntolned Ob Imeyhorcicgtodrt4elloivadbyinly. • r WalvsrSd�rrafure; S Iowa C�r>imz aal Mato cord( �heek�ea1Y f� , (DCl nsu only) As of a a search oftholrovlded name end date ofbiithxevealod: 96 XoWa WminaLTifstoryRecord found withbCT Iowa attached,1)CI# DU Received Time Jan- 11. 9019 II!11AM Nn_ • Feb. 7. 2012 1:38PM Div of Criminal Investigation No. 2885 P. 7/9 IOWA CRIMINAL HISTORY DCT 00491660 FELONY CONVICTION PAGE 1 OF 3 DATE PRINTED - 2012/02/07 DCI:00491660 NAME: ELSTON,TERRY LEE DOB SEDC RAC ACT WOT EVE HAIR SKN POA 19??0113 M W 602 190 SRO BRO FAR IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19941214 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA703-1 TRAFFIC STOLEN WEAPONS TRX#: 012457201 CHARGE NO^ 03 IA STATUTE IA703-1 UNAUTH USE OFFENSIVE WEAPON OR AID/ABET TRK#: 012457203 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 TRAFFICKING STLN WEAPON -AID A ABET CHARGE CLASS: FELONY CONVICTION TRIC#: 012457201 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950926 COURT COSTS 19950926 PROBATION 4Y 19950926 SUSPENDED SY 19971003 VIOL PROG-HOPE HOUSE REVOKED DEF JUDGMT RVKD 19971003 COURT DISPOSITION AGENCY: IA05201511 JOHNSON CO 131ST COURT COUNT NO- 03 ASD/ABET UNAUTH USE OF OFFENSIVE WEAPON CHARGE CLASS: FELONY CONVICTION TRK#: 012457203 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950926 PROBATION 4Y 19950926 SUSPENDED 5Y 19971003 VIOL PROD -HOPE HOU5E REVOKED DEF JUDGMT RVKD 19971003 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 05 IA STATUTE IA908-11 PROBATION VIOLATION CHARGE CLASS: STATUS UNKNOWN TRK#: 012457205 SENTENCE DISP EFF DAT JAIL 301) J.9961213 No. 2885 P. 7/9 • Feb. 7. 2012 1:38PM Div of Criminal Investigation DCT 00491660 PAGE 2 OF 3 COURT COSTS 19961213 02 ARRESTED 19950629 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO— 01 IA STATUTE IA321-561 DRIVE WHILE BARRED TRK#: 012469201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-561 DRIVE W/BARRED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 012469201 SENTENCE DISP EPP DAT JAIL 11D 19951201 FINE $500 19951201 03 ARRESTED 19970228 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA321J-2 owl TRK#a 020006401 CHARGE NO- 02 IA STATUTE IA321-279 ELUDING TRK#: 025006402 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA321J-2(A) OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 026006401 SENTENCE DISP EFF DAT JAIL 5D 19971010 FINE $500 19971010 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 02 IA STATUTE IA321-279 ELUDING CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 028006402 SENTENCE DISP EFF DAT JAIL 30D 1997107.0 FINE $250 19971010 No. 2885 P. 8/9 Feb. 7. 2012 1:38PM Div of Criminal Investigation No.2885 P. 9/9 DCI 00491660 PAGE 3 OF 3 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF XDENTIVICATION IS A PUBLIC RECORD NUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCT. 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 Or CRIMINAL INVESTIGATION 4 Iowa Department of -Transportation Office of Driver Services (Toil Freej OM -532-1121 41 PO BOX.9204, Des Moines, IA 5039&9204 515-244-9124 8�s FAX: 515-239-1837 History Information CLEAR DRIVING RECORD Name: Elston, Terry Lee DL/ID: 434ZZ9807 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: ..........JW.'O 1, �I/J,��4 1/31/2012 Certified Abstract of Driving Record IC46 Inquiry Date: 1/31/2012 DL/ID #: 434ZZ9807(IA) Customer #: 480075 Name: Elston, Terry Lee Class: C ID Status: EXP Address: 2033 GLEN OAKS RIDGE Audit #: 4688097 DL Status: VAL Issue Date: 09/21/2010 CDL Status: None City/State: CORALVILLE, IA 52241 Expiration Date: 01/13/2013 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 2033 GLEN OAKS RIDGE Restrictions: NONE Restriction None Date of Birth: 1/13/1977 Supplement: Mailing City/State: CORALVILLE, IA 52241 Sex: M History Information CLEAR DRIVING RECORD Name: Elston, Terry Lee DL/ID: 434ZZ9807 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: ..........JW.'O 1, �I/J,��4 1/31/2012 IOWA0. ° IC46 r ..... .s Office of Driver Services pDill Iowa Department of Transportation Name: Elston, Terry Lee DL/ID: 434ZZ9807