The URL can be used to link to this page

Home My WebLink About12-118First Middle 1 Last 1. Name Wei t� mgr 2. Mailing Address 9•Z L 3. Telephone: Home tf Other: 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Yo Type of offense Where When 6. Have youn convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ee 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 chauffeurs license been suspended or revoked in the last five years? 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.d .idnwaaa 09/2010 Authorization /a- (f W l 1 Number (Office Use Only) �+. ;r11M®ill CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington Street between 8 a.m. to 3 p.m., Monday— Friday.) Iowa City, Iowa S2240-1826 (319) 356-5040 (319) 356-S497 FAX First Middle 1 Last 1. Name Wei t� mgr 2. Mailing Address 9•Z L 3. Telephone: Home tf Other: 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Yo Type of offense Where When 6. Have youn convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ee 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 chauffeurs license been suspended or revoked in the last five years? 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.d .idnwaaa 09/2010 hTAby certi�Y that 1 have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number b �k 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) r Signature of Applicant Date 6 l f lflflNHl Nf fN1NN4#1Y#pt#ff4NlffNf4Nf4*MNMN4f*lfffffl44NNfNf 1f*f 4411!!!! lN#1fNYNN4NN*Nf1Y4fff 44NN14ifffN1f11fflf 1f #fif f STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by N u 1 w 4 On this / k day of *#*****#*tY###1fffififRflIRRRN**#**##**##*fNff##*ttif*##ff##1ifNffiRlttfflfNNf*Nf1f##tfff##1flf#fllfff##*fff4#lflllflt#f#if!#1RRNRlRt4R*R 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). Sign re of Pie i or designee SignMure of/City Clerk or designee Date 1 /C;?— 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 #fIfNN#NN#i##1f 1ff#1f#111NNii##N*#####iN#1f#N+#if###4H#N1Nf+i###Yf##NNN##!###4#N#H######f###if4R#11NH##44f YrN#llfifflf#N### Office Use Only Approved application DCI report State certified driving record Website update dekflaudrivbadgaaW2010 d 09/2010 t•. Iowa. Department of Transportation -Office of Driver Services (i"o91 Free) IMiI-532-1921 PO Box 9204, Des Wnes, fA W3nE 9204 515-244-9124 ` FAX: 515-239-1837 History Information Convictions citation Date Conviction Date Certified Abstract of Driving Record ]UR Inquiry Date: 2/1/2012 DL/ID #: 239CC6458 (I.A) Customer #: 1640461 Name: Omer, Najwa EI Awad Class: D ID Status: None Address: 322 DOUGLASS Cr Audit #: 5597669 DL Status: VAL Issue Date: 10/27/2011 CDL Status: None City/State: IOWA CITY, IA Expiration 01/19/2014 CDL Cert None 522465402 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 322 DOUGLASS Cr Restrictions: NONE Restriction None Date of Birth: 1/19/1969 Supplement: Mailing City/State: IOWA CITY, IA Sex: F 522465402 History Information Convictions citation Date Conviction Date ACD ExplanationCounty ]UR 07/02/2010 07/02/2010 109/03/2010 `. .Improper Registration'�•��SZ - � I A ._...... 09 03 2010 / [._.... _ -..... B64 No Insurance Card:' _.__ _..... 10/18/2011.01/13/2012 . ... ......... .__._52,„ :IA ;E34 _Defective Lights 52 IA, Name: Omer, Najwa EI Awad DL/ID: 239CC6458 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: "'--."tie%,"Vt 2/1/2012 IOWA �? •..... Office of Driver Services Iowa Department of Transportation Name: Omer, Najwa EI Awad DL/ID: 239CC6458 Feb. 8. 2012 4:07PM Div of Criminal Investigation r cup a turf 7. UYnIY1 GIty blerfl — I-ity Or Iowa ,ity a STATM OV W " •l o)rd Check CrA in _Mstory Rep Request Form �it4Jllh�� - To, XotvaDivlsion of crimivalShvav(tgatlon Support operations Eurenu,l'1Floor 216 E. 1'n Streot besMpfrlos,Iorva 50319 -(915)116.6066 (515)125-6080 b'ax No, MU P. L1/3 DCT A000untN'umber: U)U� • (I(epplfoeblo) );,yotal t•xTY of i0MA GITV' CITY CLh, YS 03MIGR 410 n 33� n,� STRB6'C IOWA CITL TnLya 5224D Phonet uY 2_3S�_SnGt l?axl ,n vc� K/"a7 I anti rd UwtM9 OR Iowa Urlmrael Z11 -U) V LastNamo mendalnn) 'N",,, 4 Myst Name (meadatory) 1V�id(j7ol�Pril9ptecommended) all �� luG/GL Gl 0611WII Mandalo SO/P ft1/SOCU/Yi Nnmher w4mmerrded Ddo of Myth murdeloryj Varier YnfOW )IdI01'i; Withoutasfgndawoalvel' fl'om the subfeot of tho x011116 ,itComjrlote ollrainn I nis(ory rucoru nray,wr• bo rdleasnble, per code OfY.W., chapter 69z� xnr� arlmfnalhtstory rndm dJnlbkmntlotr, a�allowed )iylpvr, alsyaya T�rttVew.ReCetrse: ihafaDYrllVe parmles(onlArrhon rnYosll@anon (DCI). Anyorin�Malhlsloty daludpnwming la cohduct wtyova uiminat filstory[ecotd cfiect:�lfi the DYislon oPC,iminol `rho DOf meybo rctcs9od a4 slroWcd by,AY. Iowa crimbal1R.ecora Check Results (DcLPtcunly) As of a search of the, provided namo Gild dato of b!xth.xevoaIad; t' xo Inwo criiiiina iRistoxy)2eeoxdfound with DCT 7ovlts GYiminal fflatoxy Redord attached, DCT DCI: