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Home My WebLink About12-099Authorization Number 1,9- — q I r (Office Use Only) MIW®F�11 CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-SO40 (3 19) 356-5497 FAX 111111111100117m, APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) 2. Mailing Address J1oD S Sco-iT dA- _06. 712E NiJ 3. Telephone: Home 3Jn' 330 - 7"`(4 5 Other. 4. Prior experience in transportation of passengers: Z 4QS 0� -t L) -t 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 5-,(W( couw-7"C (9`i2- 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When ( , L.Z_ l C70L—C CO -WI-S [197- 7. 992 7. Have you been convicted of any traffic offenses in the last five years? Where When f --P_ /00 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 names) /c 0 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) derwtawdnMadg 09/2010 I hereby cert at I hav iss ed to me by the Iowa Department of Transportation a valid Chauffeur's license number �� & lie - . 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 „}R STATE OF IOWA ) COUNTY OF JOHNSON Subscribed and swom to before me On this day of 2 ✓ 'L ' / KELLIEK.TUTTLE t'e- /'� u Commleelon Number 22 r4pQ5t otary Public in and for the State of Iowa 0 YiiYii#ii#Mi#HR}RRR}RRRRR}RR#RRfttfRRRR}RRfRRRttRRRR}RBBB}RR}}RRR}RRR},tRNi}N}R#HRi}iY##i#iYifffi##fffofftflftifflfflMfffltlf111lf1tiftft# 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). 61g�A. == r of Police Chief or designee Signattuure of City Clerk or 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. Office Use Only Approved application DCI report State certified driving record Website update d.$4�2010.e osrzoto /''M Iowa Department of Transportation Office of Driver Services (Toll Free) MD -532-1121 PO Box 9264, Des Moines, IA 5030& 92D4 515-24 FAX: 515-239-18339-1837 Inquiry Date: 4/26/2012 Name: Schoenberger, Roman Tim Address: 2100 S SCOTT BLVD TRLR 40 City/State: IOWA CITY, IA 522403032 Mailing Address: 2100 S SCOTT BLVD TRLR 40 Mailing City/State: IOWA CITY, IA 522403032 Convictions Certified Abstract of Driving Record DL/ID #: 075AA1185 (IA) Class: D Audit #: 4398269 Issue Date: 06/02/2010 Expiration Date: 05/11/2015 Endorsements: 3 Restrictions: NONE Date of Birth: 5/11/1949 Sex: M History Information Customer #: 2545540 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Fail to Obey Traffic Sign/Signal Citation Date Conviction Date ACD Explanation County Jun 02/27/2008 03/26/2008 S92 Speed 52 IA 03/01/2008 03/19/2008 M14 Fail to Obey Traffic Sign/Signal _ 52 IA 04/17/2010 05/03/2010 S92 Speed 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 7UR 10/25/2007 398870 IA 09/12/2008 460768 IA 10/06/2009 531782 IA Name: Schoenberger, Roman Tim DL/ID: 075AA1185 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: �: """•:;`/4k 4/26/2012 IOWA . yf""• Office Driver Services S`= = of ,\\DRIVER; Iowa Department of Transportation Name: Schoenberger, Roman Tim DL/ID: 07SAA1185 May. 8. 2012 2:26PM Div of Criminal Investigation , P. 6/9 6i.y vicin ei:y vi ,oaa Viiy 1�No.3606 No.L]9j F. L isTATYJ (OP IOWA i7>rflxuiarnal-MstoxyRecord Check T'o1 Yovabfv;stosta(CrhninalYnvasttgar(on Supp ort operations laaronu,14, V18 or .213 E. 714 Sfreot J)eaMq[Fj@s,l'o,ya 50329 (51S) 729-6066 (615) 725-6o90 lrgyz I ani requosthta oalowa Crim LA—dN)I S9 (mandaarp ' bc,o6('5v �12C Amro oP$irlh mandatary � ►� 1�1� Waiveaxi Jn)Madon, withou bo roleaAahleb per Coda o fXaWa, o6taFh a wa[vnrs(ann(ure A•ona t �Ilt�e/'X(ela![Se:YhorrDygfva perm �+lrosn@eaan(OCp, Artyodminalakwwd FYaiVEyawmi'fQi 0611der ACI tLccountlVllm6er, 2/0002 �% ' QrapplrrBbfa) 1�romt _ CITY 0)7 x0yi CITSY CITY am's Olnux 410 R. t1$WW'TON snRm IM Q,7T9' 10A 57240 ph o4 e1 31.9•••35E-.5041 Moxa 319 g5g5[y97 ;heok on' , -T-c- is TATYJ TZ I Zmare , Llpomare I 12- l 4D S9 l s - C Wafvor.A�om tha,vuh(ootoftn4regaast, a rompleta arim(na[fi(sfary record maynot 692.2,ZTor o f'w'Irutnalfi3stotyrceordtnroimnNon,n�aQowad�glCa,W,afways fihmryyeaordeheekwflli InaA�,falon oPCrRninal et wc4bylnw. . y"Trµ vAAAAAAAAUA..WyrOVUA V A.1kGtiVA'A V•..1AUL-^^VVLAA6.Y (nCIUSOOniy) As of a search of theprovided Hama end dot* af'Gu4hrevealod; No 16wa MIAHl HIAOxy Record f0wid wjfh )) CT --r-6 rowa. wmina mstoryReeord eama tod, DCx* Y 3I q 6 .> M4 Uoul9 Yeeeived-Tim? fay, 1. 2012 12:23PM No. 5691 k' May. 8. 2012 2:26PM Div of Criminal Investigation ADDITIONAL IDENTIFIERS SC R THGH CCH RECORD *** 01 ARRESTED 19920105 AGENCY: IA0850000 STORY CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L41122601 COURT DISPOSITION AGENCY: IA085015J STORY CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1,41122601 SENTENCE DISP EFF DAT JAIL 2D 19920318 FINE $500 19920318 COURT COSTS 19920318 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURND. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YO QUZRY. DIVISION OF CRIMINAL INV GATION No.3606 P. 7/9 IOWA CRIMINAL HISTORY DCI 00431906 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2012/05/00 DCI:00431906 NAME: SCHOENSERGER,ROMAN TIM SCHOENBERGER,TIM DOB SEX RAC HGT WGT EYE HAIR SIQN POB 19490511 M W 601 190 SRO BRO NY ADDITIONAL IDENTIFIERS SC R THGH CCH RECORD *** 01 ARRESTED 19920105 AGENCY: IA0850000 STORY CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L41122601 COURT DISPOSITION AGENCY: IA085015J STORY CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1,41122601 SENTENCE DISP EFF DAT JAIL 2D 19920318 FINE $500 19920318 COURT COSTS 19920318 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURND. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YO QUZRY. DIVISION OF CRIMINAL INV GATION No.3606 P. 7/9