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Home My WebLink About12-035� r CITY OF IOWA CITY 410 East Washington Street Iowa City.lowa 2240-1826,/ 56-SO40 FAX 1. Name 2. Mailing Authorization Number /19--8s (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 3I/ YOD- //13 Other: 4. Prior experience in transportation of pas engers: Cot / % ✓C/�i 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 6. Have you b n convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?. 9 Tvoe of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When EF When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A16;7 Type 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) AILS 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) dedOaxldrry adg 09/2010 I h�,[e y certi�Y that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number 5� i1C ! c/ %S . 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 provisi is of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant ` Datet7&L�� STATE OF IOWA ) COUNTY OF JOHNSON 1 �bscribed and worn to before me by Snw �� Sgp� 1<<�nev� On this �u day of -c)o �., •ar O t'-�� in and for the State .7 (--s i###tifRt*tR*t*ft*R*tRf R1RRRffRRRRRRR#RR#*Rf*1RRR111fff4ff444#fif#4#4f*4#M44t*ff*fRfltlff4fi+ff#Hf#444ft4ff*tYt*tR*ftf4lf#t1f#f#4f44f44YY4*#44f# 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). ombe Sign re ofI' a Chief or designee Signa re of City Clerk or designee a �V is Date -3/- /2. 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. R##M+##!i###*#t*############M##'H#f#+###1f#i#11Mf1HMffffifffflffflffflf***Y**H###f+f##YffffNflfflffflfffff**#*#*i###**f#f'F*fflflfffff'ffiifi Office Use Only Approved application DCI report State certified driving record Website update da =iddveadgeaW2010d 09/2010 Iowa Department of Transportation office ut Driver Services (Toll Free) BOU-532-1121 PO Box 9201, Des Moines, to 5D3115 -92D4 55-234-9124 FAX: 5715-239-1837 Certified Abstract of Driving Record Inquiry Date: 2/10/2012 DL/ID #: 332AE1495 (IA) Name: Kennen, Samuel Joseph Class: D Address: 308 E BURLINGTON APT 106 Audit #: 4866587 None Restriction Issue Date: 12/07/2010 City/State: IOWA CITY, IA 52240 Expiration Date: 05/03/2014 :02/12/2010 D72Fail Endorsements: 3 Mailing Address: 308 E BURLINGTON APT 106 Restrictions: NONE M 81 _ ;Careless Driving Date of Birth: 5/3/1973 Mailing City/State: IOWA CITY, IA 52240 Sex: M History Information Convictions Customer #: 1925346 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Fail toObey Traffic Sign/Signal. wy Citation Date Conviction Date ACD ExplanationCounty ....._ ....._. ...._ 3UR ._.._:. _...F. ..._...._.._.__ .._. 04/04/2006 06/02/2008 06 yaw..O _.__ Passing School Bus X52 =IA 04/13/2009 _ ,._ _:04/18/2009 _ _M75 M14 _ Fail toObey Traffic Sign/Signal. wy 4 _ 52 IA µ„ =IA 02_/09/2010 :02/12/2010 D72Fail to Have Vehicle Under Control •52 _ w. 07/17/201 0 :08/15/2010 M 81 _ ;Careless Driving 52 ;IA i Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number . ....___ ............ ..... 02/09/2010 565881 JA Name: Kenner, Samuel Joseph DL/ID: 332AE1495 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: '""•••:!`%'y 2/10/2012 ).0.T.:moo r DRIVER Office of Driver Services yaw..O Iowa Department of Transportation Name: Karmen, Samuel Joseph DL/ID: 332AE1495 Feb; 14. 2012 11;36AM Div of Criminal Invest"igat ion! STATE OV 1®WA t i y c riimisaaMstox'y Record Check 1'0; XowabiG7alo7+ofCFlrntnnlYnVesttgat(on �oppor[ OpaYPfl161191�U1'oA$ i't$iooC 2152 7'4 BirooC besMaMas,xolvq So519 (51s) �a5.6o66 (515) 725-6000 Pat N, ON .3919 (P. X1/4 VVV 0 7DC1AccoUnCNbmber; 4cca`"� O �PD�regDlc) ~ From OTT' �+ TALOA 9TmY CITZ CLEM's Opi+xOx Alp V- MSMGTM 3TR=V IOWA CITK xo17A 512740 Phana, q]4�9z6 59[1 )7nXI WYOSi�Y• Zr7r`03lE�Yf/eall219yG�ita7llplo3OrclDlygVi4vSetpheormtlfiCs5ah(dq9n�IQfotnreOiOdt6o'9a4VEZgoyI2Ve Male ,ol)lonny�tiioha elo4atldeal'6el,or(elemoc¢blidonPfnalahohpoi% sYtwseoatIr�yondetmse(i',ennnqlrhtdfoatmr�nnryfpattYeemelearndctYc/hioretrge,Jlnnnlp9rlt®hAglN(nsaWfAoCrVdyfo6lCoyenCo1opfYVe7, bo1.41,psnb,perCode;Ofy6Wp obraingw4 r 0nafureA-ornthe.suh o6nTAbYe it -o", YY ja Ifo 0co. ay did� nmAti(anW}a ('n ry1so C oriminallilscotydataepnwmfggpt 1 11ljrreln�N dhygral�,,iFmAy6orefe asaltotvcQCyin�v. AV TV 4 lillllull[U..P.1 L)LUxy J.iM: VJU. a.AVVSA AAM UAty (pCl urp only) Ag of a — ! I— I a , a searci> of the provided Hama tjiYd ciato ofblYth xavoaied ; No xbu CrImf nl H!story Record found with MY Iowa Criminal Histo,gRecord attached,Mlit bClinitial� . Received Time Feb. 9. 2012 3;OOPM No.8715 0 Feb -14. 2012 11:36AM Div of Criminal Investigation IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00451531 NAME: KENNEN,SAMUEL JOE KENNEN,SANUEL JOSEPH XRUNON,SANUEL JOSEPH DOB SEX RAC HGT WGT 19730503 M W 603 190 DCI 00451531 PAGE 1 OF 3 DATE PRINTED - 2012/02/14 EYE HAIR SKIN POB GRN BRO FAR TN ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 19921218 , . AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L42115801 COURT DISPOSITION AGENCY: IA0520i5J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L43115001 RESTITUTION SENTENCE JAIL 4SH FINE $500 02 ARRESTED 19950326 AGENCY: IA0920100 CORALVILLE PD CHARGE NO- 01 . IA STATUTE IA321A-32 DRIVING UNDER SUSPEND TRK#: 014624201 COURT DISPOSITION AGENCY: XA0520151 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 014624201 SENTENCE FINE $250 03 ARRESTED 19950406 AGENCY: IA0520100 CORALVYLLE PD CHARGE NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION TRK#: 014626201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION DISP EFF DAT 19930910 19930910 DISP EFF DAT 19950519 No.3919 P. 2/4 Feb.14. 2012 11:37AM Div of Criminal Investigation DCI 00451531 PAGE 2 OF 3 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 014626201 SENTENCE DISP EFF DAT FINE $300 19950519 04 ARRESTED 19950524 AGENCY: IA0160000 CEDAR CO SO CHARGE NO— 01 IA STATUTE IA321A-32 DRIVING WHILE LICENSE SUSPENDED TRK#: 012726701 COURT DISPOSITION AGENCY: IA0160ISJ CEDAR CO DIST COURT COUNT NO— 01 IA STATUTE IA321A-32 DRIVING WHILE LICENSE SUSPENDED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#c 012726701 SENTENCE DISP EFF DAT PLEAD GUILTY 19950511 FINE $350 19950511 05 ARRESTED 19960417 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401(3) POSSESSION/SCHEDULE I/MARIJUANA TRK#: 024159501 CHARGE NO— 02 IA STATUTE IA727-2 SALE OF FIREWORKS TRK#: 024159502 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA124-401-3-2 POSSESSION /CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 024159501 SENTENCE DISP EFF DAT FINE $300 19960906 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA727-2 SALE OF FIREWORKS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 024159502 SENTENCE DISP EPF DAT FINE $250 19960906 No. 3919 P. 3/4 .Feb.14. 2012 11:37AM Div of Criminal Investigation DCI 00451531 PAGE 3 OF 3 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA bIVIS1ON OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY B$ I2ELEASEb TO MON-LAW ENFORCEMENT AGENCIES BY THE DCS. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASEb ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No. 3919 P. 4/4