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Home My WebLink About12-029Fir l Middle ast 1. Name fjr V'4 l: ,e �,tiK ,.t at 1rLl 2. Mailing Address i5-5 3o571Ofr1 wad C-� '✓l�v�!� S�� `( 1 3. Telephone: Home 3 f`t 5- ) 6 3 G f Other: _ 4. Prior experience in transportation of passengers: C(cl 614pnf4i I 7WIc 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? , Lt c) 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?Jt� Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? C Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? L Tvoe 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) /L/C) 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 tuidrivbadg 09/2010 Authorization Number �o� —C)—% r t (Office Use Only) IIIOT +. ywl®ill 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 S2240-1826 (3 19) 356-SO40 (3 19) 356-5497 FAX Fir l Middle ast 1. Name fjr V'4 l: ,e �,tiK ,.t at 1rLl 2. Mailing Address i5-5 3o571Ofr1 wad C-� '✓l�v�!� S�� `( 1 3. Telephone: Home 3 f`t 5- ) 6 3 G f Other: _ 4. Prior experience in transportation of passengers: C(cl 614pnf4i I 7WIc 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? , Lt c) 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?Jt� Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? C Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? L Tvoe 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) /L/C) 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 tuidrivbadg 09/2010 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number S Y i 7 7 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) n c t Signature of Applicant r✓ Date R4R*4R*RHIRRRIIRR**R*f fR1Y4HNf ffY1NlNYffNHf f ff Yf f 11HMNf*!H4*11**t44H4**##f*#N**YNNNNYYHfH1Nf IfHHHHf f**4*H**f**H4*4H44 STATE OF IOWA ) COUNTY OF JOHNSON ) sc ibedand sworn to before me by I r AO �{ �� rac_c 4� . On this q44-\- day of IZ— �e c -L ,-e IC (u+(t� e a s Notary Public in and for the State of Iowa 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). -7- gnatu a of Police Chief or design_e_e. Sign lure of City Clerkor designee 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. N1f.HNNYN.1NfY*NYYNNNNNYNN44«N*YYi.!*4YNt*NitN*Y*##N1N.NYNRNIN.HN.fHN1ff-lf-fHf.1*+FHeNH#HH*Y;44YRd4!#f4YH#4HHN Office Use Only Approved application DCI report State certified driving record Website update d�d�ada W2010.� - 09/2010 Feb. S. 2012 4:07PM J I V• L. LV I L 14- IV I .'I 1 • Div of Criminal Investigation VI IJ V161n VI IJ VI rVRe VI1� STATlE (OF IOWA Criminal -History Record Check Requ(mID Form 10: IowaDtvisloh drCrIM111al I(lvesUgattoh Support Operatlone )3urettu, l't Rzoor 215 x. 716 Strood boa MolneS,Ie)ya 60319 (SIS) 729-6066 - (515) 726-6080 )ja-A hNo.ty 23 IP. L3/3 )aCiAccounCDium6er: �i002-- �— ' fepplltab e) kYom: c1°l'Y nx 7•owA In= CITY Cb sUXTS OrACE 410 R. VAa7I1)ZGTON STlziiW TO•Ork 0IT4' XWA 52240 PhonA; 379-956-5041 lrax; 319-356_5,697 N i� �awjql d L Date ootoly) 1150010800Yri MMber rcWhIntonao 07-001-0 %7 BMale OPettiRlo q (5� — p� 0 371 �RdV01'rl{JO� iiagtro,�: Wi thou[ a signed IvalYel' nom IhesuhjeeG of thn regIxest, a Complef0 cl llulnal hfsfary recor411(rty llod hordfoobble, per Code oeYoWa,Chapter07.,a..lrorCo l0t'crlminalh9rtoryrocol'dlufofmntloh,asal)o�vddby law,pl(YAys YYRiYeN ti�Ce((y g; l horo6yafv0 pararls9(oR t1 rtlto IboyoregLeflrngoNcief fo eonduol nq lolvAorllnfnalhlslotyfecard cheek With he D�islen ePCclmrndl Tnrrstigatian(OCn, 4y a rin)lnetAtstotyJaw6onmadingMoswramafntolned6ytheDOrnPYborelcuodwelfowcdbylnLv. & of o? zf a s search of the 11xov1ded xlamo and date ofbi(lhxevealodl go -rows CYINhial HistoryRcoord found with)DCI ® YOW4 0vmft(aIR1fitogReeord attached, 1)(X 13CZ Received Time Feb. 2. 2012 12:16PM No, •,1 Iowa Department of 'Transportation Office of Driver Services (Toll Free) 80-532-7721 �42 PO Box 9204, Des Moines, lA 5030"204 515-244-9124 FAX: 515-239-1837 140 Certified Abstract of Driving Record Inquiry Date: 2/3/2012 Name: Nunley, Donald Legere Status: Sr Address: 955 BOSTON WAY APT Status: 2 City/State: CORALVILLE, IA Supplement: 522413180 DL/ID #: SSSYY7573 (IA) Class: D Audit #: 3628863 Issue Date: 08/21/2009 Expiration 07/01/2014 Date: Endorsements: 3L Mailing Address: 955 BOSTON WAY APT Restrictions: Corrective Lenses 2 Date of Birth: 7/1/1967 Mailing Clty/State: CORALVILLE, IA Sex: M 522413180 History Information CLEAR DRIVING RECORD Name: Nunley, Donald Legene Sr DL/ID: 555YY7573 Customer #: 1591551 ID Status: None DL Status: VAL CDL Status: None CDL Cert None Status: CDL Med None Status: ' Restriction None Supplement: Office of Driver Services 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: '•.'i%'4 2/3/2012 IOWA %w4 ' �Sr Office of Driver Services Iowa Department of Transportation Name: Nunley, Donald Legene Sr DL/ID: 555YY7573