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Home My WebLink About12-0785. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 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? Q Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? S Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A.d Type 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 De artment of Criminal InveMR ti ation Report (form available upon request) The re- port will be mailed to the individual making t e request and needs to be revte ed by the Police Chief with this appli- cation. &, (OVER FOR REQUIRED SIGNATURE AND NOTARY) der xtdriWadg 09/2010 Authorization Number la- it r t (Office Use Only) CITY OF IOWA CITY APPLICATION FO �be (Police Department r view 410 East Washington street between 8 a.m. to 3 p.m., Monday - Friday.) Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX First Middle Last 1. Name-TMWAII;-hIJ ED 164R-17 Caa�PELIC 2. Mailing Address 31R 1.1 VaAn 'QkWWL 0 S,�LE�T T"o lLJk CA !r-1 t IiAm 3. Telephone: Home (3Irt) L3i Other: , 4. Prior experience in transportation of passengers: wgru� 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 been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Q Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? S Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A.d Type 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 De artment of Criminal InveMR ti ation Report (form available upon request) The re- port will be mailed to the individual making t e request and needs to be revte ed by the Police Chief with this appli- cation. &, (OVER FOR REQUIRED SIGNATURE AND NOTARY) der xtdriWadg 09/2010 I hereby certify, that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 4 Z — F q 3O`:l . I understand that if I falsely answer anv questions in this nnnliratinn 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 Date 0 3 yo 2.9" 0 3�22� 2_e7-7 1f##«#«#aa##a###f4####1f#«#a###aa####f##1f#efftlm+#*m44mfY44mm1f1m#k#*Y##4m4-11ff11f###*#R####maf4Yffm##*#*m#m4f}f#f*Rk*m STATE OF IOWA ) COUNTY OF JOHNSON ) c#ii ed agd swQrn tobefore me by o/ i w / 910cctceW Own/{this of ((((QQ SLII Alk VC! 1IF: K TITTLE in and for the State of Iowa 44}f4};;*k*#*R#tY#k##}1f4fff}*kk*R*#R*#*##4f41f#4}**;;RRRkR*#4f*Rf4tY#4flt}f!!f}#*#kk******#44f4kYf#111f!}Rkkk**RR*4####4#f411R41R*k*M*kf##Y#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). Si A_,___� ature 6fPolice Chief or designee Signature of City Clerk or desig e �r•,2 2-/Z Date 3 -Q-7 - /C_ 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. Office Use Only Approved application DCI report State certified driving record Website update d�dd adgeappW10.m 09/2010 �i Mar.12. 2012 3:18PM Div of Criminal Investigation }x{ mn i. U. Lv 12 L.7uIM of L I,l eln I t U luwd bl ty ► TO; XolVabt4lstohofCrlmtnal7nvacttgpt(eh Support Operarlora r3ureuu, V, 17100V 2f5g. 7'S Streot bas KOtlfaq) Iowa .503.19 (515)725.A66 (610IM-6000 is N110.o. 14Z u d Pr . 12 '1 I♦) ; RI i ty�� :��l�r''•'aeap r 1 .. - • 1 I 1 . • �i,ni�i,,j Cf�� Cheok ACI AccountNum6or: —F rle�pplrolo e> VrO M: CIT4 OR .T.OWA GIM CIV CL"XTO ORRZOV 47J1 7[_ i.YAS1iT�J'p27 qgT 70A'A CY2'Y MA 52Z40 PhonO; q��a�fi-,�;n49 . PAY; 979 95f�5b4� I ��OLI..`,�LL I ��i�✓64-'i%� I �DWI�'tz.� O��l aAz 99 — 117Caie ❑b"emare �(�(o ^ 9� — 98 �RiV91'%+fvY7nufPA>r;Wlthoutaslgna$•{yrl(yerlYomtGasubJactoPthoreg�reesF,aromplotoortrq1pplhlsforyCeCordmal�noG hoA'olepspble,bierCodeo£7o{Vp,Chapterhistoryraebrdiorvrmaalo%asaltowod$y/n-i,always IYqY9JITAelra1( CO ly1 Ag of 'b ef El 1nr,r by rnpr�gl Received Time kq,, Iselon for�hon>tovarequal(eg oafolGl fo wnduo(Ml'owa odmfnll htrroly aeord chwkwiih 1gaDtilabn oPC,hnlnll amconeomfngmo)hpr.4marnlelnodby,ho➢OTmoy6aroleaaednv elfowednytaw .lE��ot< ecordi �hec��esrxlts . • roctllrea�iy, a search of Wo pro'vfded name and dQto of birth-meaied, ' 1 No Zovlu CShninalI-lisi'opjr ltecoxd found wlthD CX 7o m Criminal Satoxy ltaeord attaohed, DCl # T. B. 2012 2:56PM No. 1113 Iowa Department of Transportation Office of Driver Services (Toll Free) 800-532-1121 PO Box 9204, Des Moines,lA 50306-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 3/22/2012 DL/ID #: 426AF4309 (IA) Name: Goupell, Johnathan Class: C S'�c-- Edward Lk \`RIYE,-,' Iowa Department of Transportation Address: 319 N VAN BUREN ST Audit #: 5873607 Issue Date: 03/21/2012 City/State: IOWA CITY, IA 522452849 Expiration 04/10/2015 Date: Endorsements: NONE Mailing Address: 319 N VAN BUREN ST Restrictions: NONE Date of Birth: 4/10/1982 Mailing City/State: IOWA CITY, IA 522452649 Sex: M History Information Convictions Customer #: 5541816 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 JUR 11/13/2010 12/15/2010 ,S92 Speed (10 mph & under in 35-55 mph zone) 52 IA Name: Goupell, Johnathan Edward DL/ID: 426AF4309 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/°4 3/22/2012 IOWA?', 1--4 alto� D. 0. % 7F •••.. Office Driver Services S'�c-- of Lk \`RIYE,-,' Iowa Department of Transportation Name: Goupell, Johnathan Edward DL/ID: 426AF4309