HomeMy WebLinkAbout12-036N ' I A'l
CITY OF IOWA CITY
410 East Washington Street
Iowa wa 52240-1826
19) 356-5040 c`� X13
� — _04
(3 19) 356-5497 FAX
First
1. Name c rd, r- I
Authorization Number
APPLICATION FOR TAXI DRIVER
(Police Department review must be made
between 8 a.m. to 3 p.m., Monday — Friday.)
Middle
2. Mailing Address _y . (� N �2 (ZIq r--
3.
3. Telephone: Home Other:
4. Prior experience in transportation of passengers: rnP447 c2 n
/2 -3�,
(Office Use Only)
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 bee convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five
years?Z
Type of Offense Where When
7. Have you been convicted of any traffic offenses in the last five years?
Type of offense Where When
Fa_ Iic rC �a Sia of Si 7 �w� �i l � CJn QS Zcu
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8. Has your drive lcense or chauffeurs license been suspended or revoked in the last five years? n
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)
,,,Q.EPAUMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND'STAT
DRIVII i� RE�COR UST ACCOMPANY THIS APPLICATION FOR POLIO C HIIEEF R�EVI
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)
den middvbadg 09/2010
,S
I her, by certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number,
cj (6 ? I understand that if I falsely answer any questions in this application, that this
application may be denied. I un erstand 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 S c6y sa , A SftA Date 2—( q
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STATE OF IOWA )
COUNTY OF JOHNSON )
ibed and sworn to before me by
OIZ
�:O_kII' Ky On this ' "v day of
I� c_L l� 1 ��_+F� ,
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).
Signatu a of Police C1.0 or de ignee
Signatuka of City Cleric or designee
Date
--/41-1,
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.
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Office Use Only
Approved application
DCI report
State certified driving record
Website update
d«w drrvcadyaaW2010 d 09/2010
Iowa Department of Transportation
Office of Driver Services (roll Free) 80-532-1121
PO Boat 9204, Des Manes, to 503M204 515-244-9424
FAX: 515-239-1837
Inquiry Date: 2/14/2012
Name: Ahmed, Sabir Bairm
Address: 342 FINKBINE LN APT 9
City/State: IOWA CITY, IA 522461714
Mailing Address: 342 FINKBINE LN APT 9
Mailing City/State: IOWA CITY, IA 522461714
Convictions
Certified Abstract of Driving Record
DL/ID #: 379AE0163 (IA)
Class: D
Audit #: 5614038
Issue Date: 11/04/2011
Expiration Date: 11/04/2013
Endorsements: 3
Restrictions: NONE
Date of Birth: 8/1/1972
Sex: M
History Information
Customer #:
5486346
ID Status:
None
DL Status:
VAL
CDL Status:
None
CDL Cert Status:
None
CDL Med Status:
None
Restriction
None
Supplement:
Citation Date Conviction Date ACD Explanation County IUR
. .�.�..�.._. r....... ..____..._.._.__. _... .. _ ._._...,.._. _ �_..._. ......._._ _ ..._ ..__,....�_._.. _ _.._._....__. _ ....._ _....._...._...
08/07/2010_ '09/07/2010 _ ;S92 __ -Speed _ X52 ,IA
07/31/2011 X08/24/2011 .592 ;Speed (10 mph & under in 35-55 mph zone) :52 ;IA
Name: Ahmed, Sablr Balrm DL/ID: 379AE0163
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:
;. •"•"• .�%p'i4
2/14/2012
IOWA
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D. 0.
9f OAI��=
Office of Driver Services
Iowa Department of Transportation
Name: Ahmed, Sabir Bairm DL/ID: 379AE0163
Feb. 10. 2012 12:1OPM Div of Criminal Investigation No, 8619 P. 2
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As of a search of the provided name and dato of Mahxdwaled. '
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DOL77 (08/25/10) /
Received Time Feb, 6, 2012 11:33AM No, 2506
City Clerk - Listing of Authorized Taxicab Drivers
Page 1 of 8
Citizen Service Center I News I E -Subscriptions I Jobs I Calendar I Store Search our Site search... go
A -Z Index I Residents I Government I Business I Visitors
ICDov Home n Permit n City Authorized Taxi Dnvers [ Print this Daae
Authorized Taxi Drivers
To resort the table, click on a column heading. Click the column heading once more to
,1 change the sorting direction.
Auth First Name Middle Name Last Name Expiration Other Notes
# Date
Adjust Text Size 11- Mohamed Abdalla Abaker 9/1/2012
152
ICpov Home 11- Hosam Mohamed Abdalazez 10/12/2012
Permits 208
Use of Public Ways 11- Mohamed Eisa Abdalla 9/6/2012
Sidewalk Retailing 161
City Authorized Taxi 11- Morwan Mohamed Ahmed Abdalla 9/16/2012
Drivers 184
Taxicab Company 12-69 Jalaleldin Rahemtalla Abdalla 3/1/2013
Listing with Vehicles 11- Mohamed Hassan Abdelkarim 10/11/2012
Grants & Loans 205
11- Yasir Hashim Abdelrahman 9/1/2012
155
12-33 Muna Magribi Abo Elhassan 2/13/2013
12-32 Adil Daoud Adams 2/13/2013
11- Mukhtar Mohamed Adarob 7/12/2012
113
12-50 Abalaziz Omer Ahamad 2/23/2013
12-28 Ali Omer Ahmed 2/8/2013
12-36 Sabir Bairm Ahmed 2/14/2013
11- Ihab Kamal Eldin Ahmed 7/22/2012
116 Elshiekh
11- Osama Mustafa Ahmed 10/12/2012
207
11- Emadeldine Bairm Ahmed 9/22/2012
189
12-54 Pamela Sue Alawneh 2/27/2013
11- Joel Frank Alexander 9/29/2012
197
11- Mazin Hassan Osman Ali 9/16/2012
182
11- Muntasir Hassan Ali 9/1/2012
153
12-61 Samir Isameldein Ali 2/28/2013
12-15 Kevan Michael Allison 1/20/2013
12-73 Ghanim Malik Alwaan 3/16/2013
11-96 Agbeko Amenounve 5/31/2012
11- Samir Taha Amin 10/19/2012
213
12-6 Neil Sterling Armstrong 1/12/2013
11- James Joseph Arthur 12/8/2012
245
11- Shawn Andrew Augustine 9/6/2012
162
http://www.icgov.org/default/apps/clerk/taxi/ 4/23/2012