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Home My WebLink About12-101�FGc•r� �� t t 6. Have y years? 71-V R_ convicted of operating a motor Type of Offense Where C.o 7. Have you been convicted of any traffic offenses in the last five years? �S Type o�nnise Where g'� et t 'r" f �- 1F. I L ry Eo< w act rC.n� c� 5�aa I,c x� �Qrn�h xti 8. liarcyour drivers license or chauffeurs license been suspended or revoked in the last five Type of offense Where the last five When ears? rs? / V1C When 9. Have you (ever applied to bean Iowa City taxi driver using a different name? If yes, please provide the name(s) V 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) uarMuid wade 09/2010 / L-1 — /C Authorization Number t 1 (Office Use Only) str'lll a CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 41 0 East Washington Street between 8 a.m. to 3 p.m., Monday— Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First Middle Lot 1. Name 2. Mailing AddressSSS 1� Ct C_ KC' /yVk C, 3. Telephone: Home I Other: 4. Prior experience in transportation of passengers: z )� ,�5 cti 7G'5 - 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 1):: ' .c '�Wjc bc.I'a L_ x.,e_ cc_±7 7/.F/0z__ �FGc•r� �� t t 6. Have y years? 71-V R_ convicted of operating a motor Type of Offense Where C.o 7. Have you been convicted of any traffic offenses in the last five years? �S Type o�nnise Where g'� et t 'r" f �- 1F. I L ry Eo< w act rC.n� c� 5�aa I,c x� �Qrn�h xti 8. liarcyour drivers license or chauffeurs license been suspended or revoked in the last five Type of offense Where the last five When ears? rs? / V1C When 9. Have you (ever applied to bean Iowa City taxi driver using a different name? If yes, please provide the name(s) V 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) uarMuid wade 09/2010 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number i ? e Y r0 Z -� -1 . 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 /,,4� / L— Date S/1 1/ 1 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by C�c , ; d R01-, z r., c, a — On this �_ day of *»4f *f #4f #kk#4f»44#R4Hf#if}H!f 4Rf1Hf»!f f 44Rf»fRRi}}R!f f44it#}kkk#4f #41##Y#4i*Hf #*1!#f#fRtlRRllff 1111 lfHIRR»»}4441!41##k*3}##4!Y}*#}f 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). S��P6 Police Chief or designee �� Signatu of City Clerk or designee Date -6�-/5- i a. 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. ff YHHYffMYYHfYY+Y+Y+Hf#f+HHH+i}+i+++++++f++++f#++HifYH#f111f1f fYHHfYHff f+RHfYHf+f+f+H+++##++iiflHHHfhflfHHYHllfff}YYYYYYH Office Use Only Approved application DCI report State certified driving record Website update deWt"dnvG dg app=0 doc 0912010 Iowa Department Office of Driver Services PO Box 9204, Des Moines, IA 503116-92B4 Inquiry Date: 5/15/2012 Name: Rotzinger, David Roy Address: 505 D AVE City/State: KALONA, IA 522479592 Mailing Address: 505 D AVE Mailing City/State: KALONA, IA 522479592 Convictions of Transportation (Toll Free) BOU-632-1121 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record DL/ID 4: 770YY0277 (IA) Class: D Audit it: 5016398 Issue Date: 02/16/2011 Expiration Date: 11/11/2013 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 11/11/1977 Sex: M History Information Customer #: 534866 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: _ 05/07/2009 Citation Date Conviction Date ACD Explanation D. 0. T.:� % County 3UR 11/08/2008 ,12/17/2008 Iowa Department of Transportation Speed (30 mph & under in 35-55 mph zone) 16 IA _ 05/07/2009 '06/01/2009 :S92 Speed 52 4A 10/19/2010 .11/22/2010 .592 (10 mph & underin 35-55 mph zone) 52 IA SIA 12_/23/2010 _ _ __ - 02/01/2011 N01• 'Speed •Fall_to Yield Right of Way 52 01/27/2011 02/16/2011 :592 Speed (30 mph & under in 35-55 mph zone) 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 3UR 12/23/2010 j609302 'IA Name: Rotzinger, David Roy DL/ID: 770YY0277 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: C•........ Y/."4 5/15/2012 IOWApJ D. 0. T.:� % , 77 �A • •' $ - "rJsr' Office of Driver Services Iowa Department of Transportation Name: Rotzinger, David Roy DL/ID: 770YY0277 State of Iowa Division of Criminal Investigation 215E7"'St Des Moines IA 50319 Ph. 515-725-6066 Fax 515-725-6080 Iowa Criminal History Record Check Walk -In Request Your name ,,, 4 ; Address $5o ,✓C - Ci /State/Zi k, l o r- Z2 Phone# 31 q _ G 2 I - fo yS Recuestina an Iowa criminal history record check on: Fill in all shaded areas. Last Name Apellido (mandatory) First Name Primer Nombre (mandatory) Middle Name Segundo Nonvbre (recommended) Date of Birth Fec)ZNacimiento(mandatory) Gender Genero (mandatory) Social Security Number (recommended) ' -7 -� 16iMale ❑Female tl'73 -rs _ G Z q I i 9 / Waiver Signature Finna (If the request is on yourself, please sign. If the request is on someone else, write N/A.) I aIVSEONLV Results / 171-1 N As of �1-;L a name and date of birth check revealed: ;r �..- ❑No found f-r7 G � Lo `rl — record JJ695-57 -� Record attached, DCI # / 11e_. O DCI initials Receipt Number of requests($15.00 per last name = Total amount $ fix Method of payment: Ocash ❑money order ❑check # El MasterCard or Visa Cardholder's name Last 4 digits of MC or Visa DCI initials Credit Card Number # Exp. Date IOWA CRIMINAL HISTORY DCI 00569557 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2012/05/14 DCI :00569557 NAME: ROTZINGER,DAVID ROY DOB SEX RAC HGT WGT EYE HAIR SKN POB 19771111 M W 509 240 BLU BRO FAR IA ADDITIONAL IDENTIFIERS SC ABDOM SC R KNEE CCH RECORD *** O1 ARRESTED 19980209 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA715A-7 FORGERY TRK#: 016545401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA715A-7 FORGERY CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 016545401 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19980710 COURT COSTS 19980710 PROBATION 2Y 19980710 PRISON 5Y 19980710 PRIOR ORDERS 20000619 CONTINUED REVOKED 20000619 02 ARRESTED 20020705 AGENCY: IA0280000 DELAWARE CO SO CHARGE NO- 01 IA STATUTE IA321-561 DRIVE WHILE BARRED TRK#: 059782701 COURT DISPOSITION AGENCY: IA028015J DELAWARE CO DIST COURT COUNT NO- 01 IA STATUTE IA321.561 DRIVING WHILE BARRED/ HABITUAL OFFENDER COURT CASE ID: 01281 AGCR00SS21 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 059782701 SENTENCE DISP EFF DAT SUSPENDED PRISON 20020809 03 ARRESTED 20060927 AGENCY: IA0520000 CHARGE NO- 01 THEFT/ 1ST DEGREE TRK#: 101987601 JOHNSON CO SO IA STATUTE IA714.2(1) DCI 00569557 PAGE 2 OF 2 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714.2(3) THEFT/ 3RD DEGREE COURT CASE ID: 06521 FECR077354 CHARGE CLASS: NON CONVICTION TRK#: 101987601 RESTITUTION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20061208 FINE $625 20081208 PROBATION 2Y 20081208 DISCHARGED FROM 20101207 DEFERRED JUDGEMENT 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 FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION