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Home My WebLink About12-122'I r 1 ' yYl®rCll CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 13 19) 356-5040 (319) 356-5497 FAX I•tA Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) /�_ - /a 9 - (Office Use On 3. Telephone: Home 3/q 646 5ry q o� 4. Prior experience in transportation of passengers: Other 3/9 fel / 4a /I i o 1^ 4CAC t 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? O -Acer )jr an C- r.;Y\; no.( Ar r Type of offense Where When krV 7 6. Have you bee convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of off1e,nse Where When 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? //l0 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) 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) den dnvbadg 00949 ol,(;?o11 I hereby certify that I ve issued to me by the Iowa Department of Transportation a valid Chauffeur's license number (7 q'2 L ,,Ove $ . 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) /'�_ _ �7 Signature of Date /._ }%+***H4ff f#f #f##f#iH#++HH+}*#*}*4fH#HHflHH##H+#+#*fH*+*****HflHfffflffHliflffH#HlififHHfIHHHHH1fH#+++}#+#*}**f*l1HHff# STATE OF IOWA ) COUNTY OF JOHNSON ssrib d and sworn to before me by ✓lO K) 4�1C �� On this �Pf V ` day of 2=L)) -Z— v? KELLIE K. TUTTLE otary Public in and for the State of Iowa �' My Co issio E fres ow 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). Date %-, i"" - /,.-L Date NOT VALID UNTIL Police Chief and City Clerk have approved and authorized taxi driver names 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 deMRav'dmbadg aW2010.tloc 09/2W o6(ao� i /'� Iowa Department of Transportation il� ,, Office of Driver Services (Toll Fns) WO -532-1121 PO Box 9204, Des Manes, IA 50305-92134 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 6/27/2012 DL/ID #: 042EE3350 (IA) Customer #: 2210311 Name: Knight, Donald Thomas Class: C ID Status: None - - III _ ,92 IA 06/08/2009' Address: 708 9TH AVE Audit #: 4854362 DL Status: VAL 92 IA Issue Date: 12/01/2010 CDL Status: None City/State: WELLMAN, IA Expiration 08/10/2014 CDL Cert None 02/27/2012 523569202 Date: mph & under In 35-55 Status: zone) 92 IA Endorsements: NONE CDL Med None mph & under in 35-55 mph zone) 51 Status: Mailing Address: 708 9TH AVE Restrictions: Corrective Lenses Restriction None Date of Birth: 8/10/1970 Supplement: Mailing City/State: WELLMAN, IA Sex: M 523569202 History Information Convictions Citation Date Conviction Date ACD Explanation County 7UR 07/2_8/2007 08/28/2007 - - - S92 Speed - - _ ,92 IA 06/08/2009' 07/07/2009m S92 ,Speed 92 IA 07/08/2010 08/24/2010 _ S92 .Speed (10 mph & under in 35-55 mph zone) 92 IA 01/08/2012 02/27/2012 S92 Speed (10 mph & under In 35-55 mph zone) 92 IA 01/11/2012 02/15/2012 S92 .Speed (10 mph & under in 35-55 mph zone) 51 IA Name: Knight, Donald Thomas III DL/ID: 042EE3350 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: ......... �v-Y it IOWA '8y'' D. 0. T.' 7F 6/27/2012 Office of Driver Services 'nye Iowa Department of Transportation Name: Knight, Donald Thomas III DL/ID: 042EE3350 Oe,J u I._ 5. 20120 3 �OOPM Div of Criminal Investigation No' 9050 P. 1 -� DCI IOf,..�....../3 /000 STATE OF IOWA Criminal History Record Check Request Form Tot Iowa DNlsloa of Criminal IaveadyQloh Support operatioaa Bureau, V Floor 215 E.7° Shat Des Moines, tows 50319 (Sts) 72S.6066 (515) 72"090 FBI DCl Account Number. (aapplinble) ' Fromr �AYLrS Tllxl (p.5�•wcNs �r• 1900. Ca k 5)-;4 o Fauna: :�314� 338- 3 4 F.rt.- 3t1 351 -U - , WTI , mlyl .....e: :.•P•-. " li,aat NamOMenrya4madnaRini Name mKidstaY) Middle Name nw2mcm 151t -Z2.00 Mile of IrtL Gender LmrA o SceW Seeurl Number rem 16 O O L9Male I31irewale ��y cl 67 Walvertnjorm neil. without s alpledrnlrer Rom the subject orthe requeay ■ complele criminal history moord may not be rsteaubQy percods of form, Chapter 6922. Forcamhk a «imlaal blstoryracord leformatbu, as allowed bylaw, always obtain a wrher PIxontow Rom the sub eel of lbs uest. Waiver Release: i hx* cin rami.eim fa da stovareyupibig anlrlal w cash ee tewa gbokol hirte,y,eemd rhxk with rM nt.tdaa arCdM1Bd 00 b"bot Cl Yh lumd ndlawcdbyllw. Imwdptbh(oCO. Ary alaofil hido;rT As of- a search of the provided aemo and date of birth revealed: 1 01 ❑ No Iowa Criminal History Record found with DCT : Iowa Criminal History Record attached, ACI N, ag DCI Received Time Jun. 27. 2012 1:04PM No, 0907 Jul. 5. 2012 MON Div of Criminal Investigation No.9050 P. 2/3 IOWA CRIMINAL HISTORY FELONY CONVICTION DCI:00389945 NAME: RNIGRT,DON KNIGHT,DONALD THOMAS KNIGHT,DONALD THOMAS III DOB SEK RAC HGT NOT EYE 19700810 M W 507 175 BLV ADDITIONAL IDENTIFIERS SC R KNEE TAT BACK CCH RECORD *** 01 ARRESTED 19890513 DCI 00389945 PAGE 1 OF 2 DATE PRINTED - 2012/07/05 HAIR SKN POE BLN FAR IA AGENCY: IA0520000 JOHNSON CO $O CHARGE NO- 01 IA STATUTE IA716-1 CRIMINAL MISCHIEF 214D DEGREE TRK#: L36116401 CHARGE NO- 02 IA STATUTE IA714-1 THEFT 4TH DEGREE TRK#: L36116402 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 CRIMINAL M19CHIEF CHARGE CLASS: FELONY CONVICTION TRK#: L36116401 SENTENCE PROBATION 2Y SUSPENDED 5Y HOME HOUSE COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA714,2(4) THEFT 4TH DEGREE - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L36116402 SENTENCE JAIL 10D SUSPENDED 170D 02 ARRESTED 19090820 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-1 THEFT 5TH DEGREE TRK#: L36116501 COURT DISPOSITION AGENCY: IA052015a JOHNSON CO DIST COORT COUNT NO- Ol IA STATUTE IA714-1 THEFT 5TH DEGREE Jul. 5. 2012 MIN Div of Criminal Investigation DCI 00389945 PAGE 2 OF 2 CHARGE MASS: MISDEMEANOR CONVICTION TRK#: L36116501 SENTENCE DISP EFF DAT PLEAD GUILTY SURCHG 19091004 FINE $75 19891004 COURT COSTS 19891004 03 ARRESTED 19B91109 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA900-11 PROBATION VIOLATION TRK#t L36116601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA908-11 PROBATION VIOLATION CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L36116601 SENTENCE DISP EPP DAT PROBATION ALCO & DRUG DEPENDENCY 19891219 SERVICE 04 ARRESTED 19940726 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401-3 FOSS SCH I - MARIJUANA TRK#: 011294101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-401-3 POSE SCH I - MARIOVANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 011294101 SENTENCE DISP EFF DAT FINE $250 19960222 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 No. 9050 P. 3/3