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Home My WebLink About12-116r it"III CITY OF IOWA CITY 410 East Washington Street Iowa i. Iowa 5 2 2 40- 1 82 (319) 356-50 -T-0rs (-11-2— (3 19) o IZ(319) 356-5497 FAX 1. Name Authorization Number /a " P6 (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) y Middle L Last 2. Mailing Address :!;�3 7 7IE6�- S?: 3. Telephone: Home 21 6SI Other: S11? 3 3 G C e. e_ 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 6. Have youbeep convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?. V Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? / Al/0 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) /yo DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAT E DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR PO ICE 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) deNta)Ambadg 09/2010 I hereby certify that I haqve issued to me by the Iowa Department of Transportation a valid Chauffeur's license number __3 y 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_ ejth all of t�rovisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of A Date !Q STATE OF IOWA ) COUNTY OF JOHNSON ) Sub cribed and svWom to before me by � a .vvw c L—Oc-�C. r— On this S� day of KELLIE K. TUTTLE NlitarV 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). of Pq)fcqChief or designee Date or 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. f*Rt****f**R***fRRY#+4**M4*+#***R4R+#R#*Rk*RM+#RR+ii#++#+ifff*#fMkfYft*YtfR*RMR#+#+*#i++YflHffllMk4*#*t**t#R*i###f#f+#lflffi##!f#ff++fffH Office Use Only Approved application DCI report State certified driving record Website update deMN dnvbadgeapp2010d 09/2010 Jun.14. 2012 1:41PM Div of Criminal Investigation _ ... V. G V I L 1 - L J I III V I l, V I l 111 V I 1 r V I 1 VII 6 V I f I ' STATE OV IOWA p ?11U17A'`Criminal t t. Tot IoAYQ Division of Criminal Invesilgatlon Support operptions Bureau, V Floor 215 E. 716 Street Des Moines, Iowa 50319 (515) 725-6066 (515) 725-6080 rax I am reQnestine an IOWA Crimiirni T-ti.Qmn 17rrm•d !'hnnG .,.- 1)C1 Account Number; 1No , 91v93 IP. X3/5 ZkOP —r— (if APP110AWO) (ifnppllcabfe) Froml _ Gi / e•/ V -/'a E r['hi/tc,yo7�s� Iowa City, IA, 52240 (319) Phonot ✓/ Faxi (319) 0 -6& — 6 7 LastName(mgndatory First Name (maudatory)" • M3ddleNl=6 recolrnmended) J MA -S Date70f1RBi7r-th(inm;da(oSOQIaI SCCU[1 lvllltllbel(recommended) J� Male , [Female 33,Z 7lie') 0 0 70� WafveYri( forinalio/t: Without Q signed waiver from the subJeeU of the regttesy a complgo crlminal history record may not be 'Oe,per Code oflown) Chapter 692.2, Form criminal hlstot•y-record ipformatlon, as allowed by iaW, always ohtainnwaiversl nuturefrom thesabeetofthe re nest, Walver'Re%ase: I hereby give permission for the above requesting aQiolol 10 conduct an foava'crlmfdel historyreceed check Will, she Divlslon of Criminol inveslisollon (DCO. My criminal history dein ooneomingme Ih ' hgalntabled b the Ix 11))a a released M ol(oWed by law. Waiversigit Iowa Criminal History Record Check Results (DCI;Iaaniy) As of /i L1 a search of the provided name and date of birth revealed; ; ❑ No Iowa Criminal History Record found with W1 c.a Iowa Criminal History Record attached, DCI # -I: DCI initials c,T 77 (n p/) </1 n) 3eceiverTime Jun, 6, 2012 4:26PM No. 1586 -Jun.14. 2012 1:41PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00262451 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- DCI:00262451 2012/06/14 NAME: LODER,JAMES R LODER,JAMES ROBIN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19531008 M W 603 245 HA2 SRO MED IL ADDITIONAL IDENTIFIERS CCH RECORD www 01 ARRESTED . 19800215 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA714-7 OMVW00C TRK#: L17618801 COURT DISPOSITION ' AGENCY: IA0920151T WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE XA714-7 OPER MV W/O OWNERS CONSENT CHARGE CLASS: STATUS UNKNOWN TRK#: L17618801 SENTENCE SUSPENDED 2Y 02 ARRESTED 19800712 AGENCY: IA0920000 WASHINGTON CO SO CRARGS NO- 01 IA S'T'ATUTE IA123-46 PUBLIC INTOXICATION TRK#: L17610901 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE IA123-4G PUBLIC INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17618901 SENTENCE PLEAD GUILTY JAIL 1D COURT COSTS 03 ARRESTED 19000722 AGENCY: IA0570000 LINN CO SO CHARGE NO- 01 IA STATUTE 1A123-46 INTOXICATION TRH#: L17619001 COURT DISPOSITION AGENCY: IA0570151T LINN CO DIST COURT COUNT NO- 01 IA STATUTE IA123-46 INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION DISP EFF DAT 19800321 No. 9193 P. 4/5 Jun. 14. 2012 1:41PM Div of Criminal Investigation - No. 9193 P. 5/5 TRK#: L17619001 SENTENCE FINE COURT COSTS 04 ARRESTED 19800720 AGENCY; XA0920000 CHARGE NO- 01 PROS VIOLATION TRK#: L17619101 COURT DISPOSITION AGENCY: IA09201SU COUNT NO- 01 PROB VIOL TRK#: L17619101 SENTENCE JAIL SUSPENDED $25 WASHINGTON CO SO IA STATUTE IA908-11 WASHINGTON CO DIST COURT IA STATUTE IA900-11 3M 9M 05 ARRESTED 19951103 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 XA STATUTE IA716-6 CRIMINAL MISCHIEF -4TH TRK#: 007790901 COURT DISPOSITION AGENCY: XAO52015J JOHNSON CO DIST COURT COUNT 110- 01 IA STATUTE IA716-6 CRIM MISCH 4TH CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 001790901 RESTITUTION SENTENCE FINE $250 PR08ATXON lY SUSPENDED 10D DCI 00262451 PAGE 2 OF 2 DISP EFF DAT 19800917 19800917 DYSP EFF DAT 19960404 19960404 19960404 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF QUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCT. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION Iowa Department of Transportation Office of Driver Services (fall Free) 600-532-1121 PO Box 9204, Des Moines, IA 50306-9204 515-244-9124 ' FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 6/7/2012 DL/ID #: 434ZZ3495(IA) Name: Loder, James Robin Class: D Address: 437 7TH ST Audit #: 5708443 Restriction None Issue Date: 12/28/2011 City/State: CORALVILLE, IA 522412016 Expiration Date: 10/08/2014 Endorsements: 3 Mailing Address: 437 7TH ST Restrictions: NONE Date of Birth: 10/8/1953 Mailing City/State: CORALVILLE, IA 522412016 Sex: M History Information CLEAR DRIVING RECORD Name: Loder, James Robin DL/ID: 434ZZ3495 Customer #: 3004564 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: =pant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am "stodian of the records held by the Office of Driver Services, that this is a true and accurate copy of an official record currently in the custody of said office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: .......... 6/7/2012 IOWA � ). 0. T..;a��t o"Opl$ Office of Driver Services Iowa Department of Transportation Name: Loder, James Rabin DL/ID: 434ZZ3495