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Home My WebLink About12-106� r 1 N M"=1 l CITY OF IOWA CITY 410 East Washington Street �37 2240-1826 AX 1. Name 2. Mailing Authorization Number / '— (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 6.�O' 7Sa" 9 yyS 4. Prior experience in transportation of passengers: ! d 1 PCO iegAp tip-, 5 farm )IYe r—�l r , Other: s h0� wnFil J- drove t4y0, �TKne MY7 - teb, -2,106) 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? VFS Type of offense Where When n yhar't 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?_ A/ 0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 7 S Type of offense Where When S, P��h>7 6�'ij fy Mone_ 2010 �pa dlna 1 .nn 1"%4Ili s�IJ s picAihee- 2vf 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? r N 0 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) 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) d.rMa tlmbadg 09/2010 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number S CCC'I L . 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 C70, Date #+#H#4#fl#H######4#H444'He###*###k*+#1F#*4##44411#+###44##1'#411 4141#N111f1f f f11f#f#Ht*R#444##f##f##f+1M+111N*#1114##Hf4#!lt#144##H#*#4#*# STATE OF IOWA ) COUNTY OF JOHNSON ) —7 y� ✓� rim and sworn to before me by On this ZZ day of 1 yyu2 KELLIE K. TUTTLE U i u TnRf 221919 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&alrure of Police Chief or designee 9 A SI re of CiqClerk or designee S =�7 2- /Z DaYtee �t: to — After Police Chief and Oity 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 da .jddwad,a,2010. 0912010 Iowa Department of Transportation Office of Driver Services (Toll Free) 800-532-1121 PO Box 9204, Des Maines, IA 5030&9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 4/11/2012 DL/ID #: 251CCO152 (IA) Customer #: 4289265 Name: Bane, Thomas Daniel Class: C ID Status: None Address: 5038 AMERICAN Audit #: 4937066 DL Status: VAL _ 09/16/2010 LEGION RD SE Issue Date: 01/07/2011 CDL Status: None City/State: IOWA CITY, IA Expiration 01/12/2016 CDL Cert None 522409070 Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: 5038 AMERICAN Restrictions: NONE Restriction None LEGION RD SE Date of Birth: 1/12/1969 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522409070 History Information Convictions Citation Date Conviction Date ACO Explanation County 7i1R 06/23/2010 07/14/2010 S92 Speed 57 IA 09/16/2010 _ 10/18/2010 _ _ _ _S92 Speed 57 IA _ 09/16/2010 10/18/2010 F04 Seat Belt Violation 57 IA Name: Bane, Thomas Daniel DL/ID: 251CCO152 Pursuant to Iowa Code 4321.10, 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: o:' ;py $o : IOWA •: 04: �4�cF�f B�IYER STSs Name: Bane, Thomas Daniel DL/ID: 251CCO152 4/11/2012 r Office of Driver Services Iowa Department of Transportation }' May. 16. '1012 11:lUNM Iv o UrlminaI lnvesliga[Ion �J.`��j■IrC■ L��• �I. cv is J.Jcim el L, Uv,n of i) vi Ivnu of ij. To, XotvablslslonafCrimtltalXmVavttgat(oh Support operallams Aurone, i"$loot 216E.716sfreot besMylaes,Tolva 50319 (51s)72o'do66 (615) 725-6040 xrn IVO. )LL I F. I/ 7 No. VfvL P. L ) ACZAaoollnW4mbea: Yvda- F ' QeapplrcabYc) *emt{ GTTZ 02 IOWA G•xT.V CX:CX GL=19 OFFXCE kin TI- TMBH (;Tol, s�BET Y�Q f��t'P TOp� ��740 Alton e7 419-.4KE�5047 )Ax. 37 g 54g7 Chaok on; I MWE I TWA 4 s II 01 I2 /ivrare de�aare ��'-opt (7iveF1VOM`s/rt101"WIthoutasigned Wsiworhomthesubja/toPthoxoquaaL, a romplofecl4m(na[hlstaty tecozdmnynot baa•oleysable, Pei, Cade ofXow(i,GbaptcrG922.6orgom Ipa<e'atjrafnAihistoxyracoz'd7nrnrmatloh,asgllnwodtyld*,0fwnys abtalhnwatvars( naturalt• m thosub oecoftltere uest; ' (6)�el �2re!lce;YhctxbygfvaplrmfoyfonforlhonboYoaaqualingorffoipltolhtrDNgfoiforcdmfnal lhrcetf@alfon (.UCp. Myortntlhelhlstory daetwnaom�fnf8nt�o lnuls m��tntolned 6y lRnnOlmoy 6a ra(epsegati eyif�otYe-4-ny intr, xi)wa Crfrllinal.mstoryple(Dord CheckRegults, AG o£- _ J�r'�i0 � %- � a seazoh O�c the,pxov3ded nartao And trate ol'Uii�,hd'evealed. < ': � .� • - , . , No loWa Cihi&al Fjstory)Z ocord fbiwd withD Cr X- YonG4hfxlalMatoryRecord attaohed,))CQ 3 J Dcl 3eceived Time'May,-11. 2012 3:53PM No.6366 May.16. 2012 11:10AM Div of Grlminal Investigation IOWA CRIMINAL HISTORY DCI 00370225 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 4 DATE PRINTED - 2012/05/16 DCI:00370225 NAME: BANE,THOMAS DANIEL BANE,TOM DOB SEX RAC HGT WGT EYE HAIR Sm POD 19690112 M W 511 175 BRO BLK FAR IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19871227 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IAI23-46 PUBLIC INTOX TRK#: L33479301 CHARGE NO- 02 IA STATUTE IA719-1 INTERFERENCE WITH OFFICIAL ACTS TRK#: L33479302 CHARGE NO- 03 IR STATUTE IA723-4-1 DISORDERLY CONDUCT TRK#: L33479303 COURT DISPOSITION AGENCY: IA052015J' JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479301 SENTENCE DISP EFF DAT PLEAD GUILTY 19871227 FINE $25 19871227 COURT COSTS $20 19071227 COURT DISP061TION AGENCY: IA05201617 JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA719.1(1)A INTERFERENCE W/OFFICIAL ACTS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479302 SENTENCE DISP EFF DAT PLEAD GUILTY 19871227 FINE $10 19871227 COURT COSTS $20 19671227 COURT DISPOSITION AGENCY: IA052015LT JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE 'IA723.4(1) DISORDERLY CONDUCT - FIGHTING OR VIOLENT BEHAVIOR CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479303 SENTENCE DISP EFF DAT PLEAD GUILTY 19871227 FINE $10 19071227 IV0.0LLI r. L/7 May. 16. ZUIZ I I:IVAM Uiv oT Lrlminal invesngailon DCI 00370225 PAGE 2 OF 4 COURT COSTS $20 19871227 02 ARRESTED 19890507 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L33479401 CHARGE NO- 02 IA STATUTE IA714-2-5 THEFT STE DEGREE TRK(!: L33479402 CHARGE NO- 03 IA STATUTE IA719-1 INTERFERENCE NTT$ OFFICIAL ACTS TRH#: L33479403 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479401 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $20 COURT DISPOSITION AGENCY: XA0520151T JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA714.2(5) THEFT 5TH DEGREE - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; L33479402 SENTENCE PLEAD GUILTY FINE $75 COURT COSTS $20 COURT DISPOSITION ' AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE IA719.1(1)A INTERFERENCE W/OFFICIAL ACTS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33479403 SENTENCE PLEAD GUILTY FINE $15 COURT COSTS $20 03 ARRESTED 19910607 AGENCY: IA0520200 IOWA CITY PD DISP RVV DAT 19890508 19890508 19890508 DISP EFF DAT 19890627 19890627 19890627 N. )LL I f. J/ ) May.16. 2012 11:11AUI Div of Uriminai investigation DCT 00370225 PAGE 3 OF 4 CHARGE NO- 01 IA STATUTE IA32IJ-2 owl TRK#: L33479501 CHARGE NO- 02 IA STATUTE IA204-401-3 POSSESS SCHEDULE I/MARIJUANA TRXR: L33479502 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204.401(3)(8) POSSESSION OF MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1+33479501 SENTENCE CORALVILLE PD DISP EFF DAT JAIL 1D 19910826 .CREDIT W/TIME SERVED 7H 19910826 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA321J-2 Owl IA STATUTE IA124-204-4-M CHARGE CLASS: NON CONVICTION TRH#: L33479502 CHARGE CLASS: MISDEMEANOR CONVICTION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19910926 DISCHARGED FROM DISP EFF DAT 19920820 DEFERRED JUDGEMENT 19950330 FINE 04 ARRESTED 19950226 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION-SCH I TRK#: 014619101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-204-4-M POSSESS MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 014619101 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT SUSPENDED :TAIL 30D 19950330 FINE $250 19950330 COURT COSTS $75 19950330 PROBATION 1Y 19950330 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IAG65-4(2) CONTEMPT OF COURT IVU. 7LLI :- Y/7 May. I6. ZUIZ ]]:]]AM Div oT Griminal Investigation 110.7zzI r. 7/7 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 014619102 SENTENCE JAIL 5D DCI 00370225 PAGE 4 OF 4 DISP EFF DAT 19980915 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 ON