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Home My WebLink About12-111CITY OF IOWA CITY 410 East Washington Street �-3 S6 o Iowa2240-1826 191 3 5040 7 FAX 1. Name 2. Mailing Address_ 3. Telephone: Home Authorization Number I �--- I I (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 2 5 -�146C Other: 4. Prior experience in trannsportationRf pass ngers: <�I,AirlPr' I Cab_ KeL('%1F 171 or+hLlher+y f4ig2V Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Thi 6. Have youp��q convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? , When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When 9. Havie 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) derk/Widwbadg 09/2010 I h(e rti v h�t,I t is ue to me by the Iowa Department of Transportation a valid Chauffeur's license number L -e. I understand that if I falsely answer any questions in this application, that this ap ication 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) yn l Signature of ApplicantOU4�P Date ( �ryt STATE OF IOWA ) COUNTY OF JOHNSON ) seribed and sworn to efore me by I V l Gil t�k v'(7/Yk S+ej✓l O^n/ Jth_is day of KELLIEK.TUTTLE Commission Number 22181 otary Public in and for the State of Iowa 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). :Al-C�& SighElture of Policeof or designee ignee ig ure of City Clerk or designee ct( //. -2e/c2 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 deMta idnvbadgeapp201o.dm 09/2010 Iowa Department of Transportation Office of Driver Services (Tall Free) MD -532-1121 PO Box 9204, Des Moines, IA 5D3Dff-9204 515.-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 5/30/2012 DL/ID #: 013BB2180 (IA) Customer #: 678915 Name: Vonsteln, Mark Wayne Class: C ID Status: None Address: 139 HOLIDAY LODGE RD Audit #: 4868268 DL Status: VAL Issue Date: 12/07/2010 CDL Status: None City/State: NORTH LIBERTY, IA Expiration Date: 12/07/2015 CDL Cert Status: None 523179518 Endorsements: NONE CDL Med Status: None Mailing Address: 139 HOLIDAY LODGE RD Restrictions: Corrective Lenses Restriction None Date of Birth: 12/7/1972 Supplement: Mailing City/State: NORTH LIBERTY, IA Sex: M 523179518 History Information Convictions Citation Date Conviction Date ACD Explanation County 3UR 06/29/2007 _:07/17/2007 ,., Speed (10 mph & under In 35-55 mph zone) .57 =1A 02/07/2009 (03/02/2009 'M14 Fail to Obey Traffic Sign/Signal 52 IA Name: Vonstein, Mark Wayne DL/ID: 013BB2180 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: • •: "�y 5/30/2012 IOWA 'I' c L +' 10. T.' MI r"•••••'•q6/ Office of Driver Services '.UBIYEEE�'= Iowa Department of Transportation Name: Vonstein, Mark Wayne DL/ID: 013BB2180 Att= S��Jc 5L!(ers RJ Cab if Jun. 11. 20121 10 : 53AN� Div of Criminal Investigation v:a, v: v:n ..,1 VI ,Vn. V.'y No.8496 P. 2/4 I V. L'YrL I. ZI L STATE OF IOWA Criminal History Record Check - Request Form -- To: Iowa Division of CrimiaalInvestigation Support Operatloas bureau, Pr Floor 215 B. 7'" Sheet Des ]Moines, Iowa 50319 (515) 7154066 (515) 725-6080 nx I am requesting an Iowa Criminal history Record Cheok on: DCIAccoun(N'umber: 4oC)a `1- (it applicable) From: CITY On IOWA CITY CITY CURD'S OFFICE 4101;. WASFMGTONSTRItIM IOWA CITY IOWA 52240 Phone: 319-356-5041 Fax: 319-356.9497 Last Nam ee(mandata .NirstName mandotory) Middle Name(rccommcndc J t MO r -k W � Date ofBirth (nlandalo Gender mandorory) SocialSecuri Umber caommended) Owe ❑Femle 5b ge3"�3Jt walverinformarlon: Without a signed waiverfrom thestlbJect of the request, R complete criminal historyrecord mnynot I bo releasable, pol' Code of Iow•a1 Chapter 692.2. For com cl'linirlathistory record information, as allowed by laws allyays obtaln a waiver slanature it orh the sub lect of the rearrest. WaiVel' 1Zelease: I hemby give pemdssion for the above rcquuting offiolld fe condaet an Iowa criminal ldstoryrcwrd ehcckwias the Division otCrlmlnl Jnvealgellon(DCI). Any aiminaiiiistbryda(AcOlicemlilgnielhatiamaintwriedhyrheDClmnybercicaaede9allowc,lbylaw, MaiverSigmature; l/� Iowa Criminal History ecord Check Results As of (0 411 a a search of the provided name and date of birth revealed: —171 ❑ No Iowa Criminal Ilistoty Record found u2th DCI Towa Criminal history Record attached, DCI #—k02 S DCT Received '1, X2012 11:07AM No. ?A7 jf' Jun. 11. 2012 10:53AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00609815 FELONY CONVICTION PAGE 1 OF 2 DATE PRINTED - 2012/06/11 DCI:00609815 NAME: VONSTEIN,MARK DOB SEX RAC HGT WGT EYE HAIR SKN POB 19721207 M W 506 210 BRO BED FAR IA ADDITIONAL IDENTIFIERS SC L LEG / CCH RECORD •�4 01 ARRESTED 19991110 AGENCY: IA0520100 CORALVILLE PD ' CHARGE NO- 01 IA STATUTE IA708-4 WILLFUL INJURY TRK#: 035757901 CHARGE NO- 02 IA STATUTE IA708.2(3)-2 ASSAULT - VSE/DISPLAY OF WEAPON TRK#: 035757902 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708.4(2) WILLFUL INJURY - CAUSING BODILY INJURY CHARGE CLASS: FELONY CONVICTION TRK#: 035757901 RESTITUTION SENTENCE DISP EFF DAT RESIDENTIAL FACILITY 365D 20001222 FINE $750 20001222 SUSPENDED PRISON SY 20001222 PROBATION 3Y 20001222 PRISON 5Y 20001222 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA708.2(3)-2 ASSAULT /USE/DISPLAY OF A WEAPON -1969 / COURT CASE ID: 06521 FECROS3425 ✓ CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 035757902 SENTENCE DISP EFF DAT FINE $500 20001222 SUSPENDED PRISON 2Y 20001222 PROBATION 2Y 20001222 PRISON 2Y 20001222 PROBATION EXTENDED TO 12/22/03 20021222 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 ENFORCE14ENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS No.8496 P. 3/4 Jun.11. 2012 10:53AM Div of Criminal Investigation BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION 11 No.8496 P. 4/4