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Home My WebLink About12-131,A� 4* �III� + r11M®iol�� CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name Authorization Number I _— 13 I APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) (Office Use Only) 2. Mailing Address U i0 61_p6A 1&nA 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: wokr t FYb1I t (Qewk- Z;wa $ u �f /eGflr dJc 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? � 2S Type of offense When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? %1(,) Where 7. Have you been convicted of any traffic offenses in the last five years? 1 P When Typeofoffense Where _ When C! kine �t,t 1.171 atV 1 Lt e .LISW 4t 8. Has your driver's license or chauffeur's license been suspended or revoked in the Iasi five years? A Tvpe 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) derVWidrivbadg 0912= Q%IzoIZ I hereby e I that I have i sued to me by the Iowa Department of Transportation a valid Chauffeur's license number in �}lry = . 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 aNimes 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 ApplicantYVJJ��SX- IVX f'.. Date_ aL STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me b 71 "d fiL av/s ,r y h�) Wr.Cn -L On this 1 � day of � SONDRAEFORT Commission Number 159791 •w-,r/��wr� �+yb 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). SSig}9attureof Ploliqe_C 'for designee Date k- 4�,,t 7-/`l- ) 9 Signature of City Clerk or designee 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 cled mdjry geepp2010.d 09am C OIao IL Iowa Department of Transportation. -P( �I Office of Driver Services (Toll Free) 800332-1121 PO Box 9204, Des Manes, fA 503013-9204 .515-244-9124 FAX: 515-239-1837 Inquiry Date: 3/8/2012 Name: Jeune, Reathel Diane Address: 846 BASSWOOD LN City/State: IOWA CITY, IA 522465813 Mailing Address: 846 BASSWOOD LN Mailing City/State: IOWA CITY, IA 522465813 Convictions Certified Abstract of Driving Record DL/ID #: 143AC9022 (IA) Customer #: 2692377 Class: D ID Status: None Audit #: 5844323 DL Status: VAL Issue Date: 03/08/2012 CDL Status: None Expiration Date: 07/24/2017 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Restrictions: NONE Restriction None Date of Birth: 7/24/1975 Supplement: Sex: F History Information Citation Date Conviction Date ACD Explanation County JUR .__ .._. ___... _ ._. _ ._._._ _ _ ._ ............ _ --- _ "' _ .... _ . _... ........ 11/20/2009 112/13/2009 ?592 Speed ,52 ;IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number _ JUR 04/11/2007 x368149 'IA Name: Jeune, Reathel Diane DL/ID: 143AC9022 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: ;' • PAP 3/8/2012 IOWA'° D. 0. T.: Office of Driver Services Iowa Department of Transportation Name: Jeune, Reathel Diane DL/ID: 143AC9022 J�,1.18. 2012 9:46AM Div of Criminal Investigation No.4234 P. 1 •Jur. If. Cul[ L'D7rivi u i L y 1,1erx — LIty of lovia Llly No. MU P. 4/4 IOWA Criminal History Record Check 40 Reqt To: Iowa Division of Cl'lmhta[ Iuvrstigatloa Support Operations )3ureau, 1"I:)oor 2115 B, I'll Street Dcs Moines, Iowa 50319 (515) 725-6066 (549) 7as-6080 rax I atn regt[estiu an Iowa Crlmtnal Hlsfory Record C[teok on; DCI. Account Numbet'; (ftoppllcnblo) rrom: CITY OV IOWA CITY CITY CI.IrRX'S OV ICJE 4110 D. WASHINCvTON STRLPT CITY IOWA 52240 khonot 319-3565041 VAX; 319.356.5497 Last Name (mandatory) I Mrs f Name (mandatory) Middle Name rocon mendea ]Date of Birt ndatory) Gwider (mandatory) Social Security Number (reeommonaea jI q�,� Male �1G'emale l-.) Oj �q�j�?Sa Waivel•Irafohlualon. without a signed WaiverfronttheSubjectoftherequest,acompletecrfminalbWol:yretordMayriot be releasable, per Co do of Iowa, Ch6pfer 692.2. For comnlefe criminal history record inforinatlon, as allowed bylaw, always obtain a waiver signature from the sub lect of the request. Waipef, -Release; thereby give pemtissloa for the above requesting ofrefal to conduct an Iowa criminal history record chcckwilh tho Division ofCrimf ell linvcsligalion(DCn.Anycriminal history, dalami ng me(flat isnsarntainedbytheDCrm bereteascdasallowedbylaw. WaiyerSlgaalure: Iowa Criminal Ristox V Recon; d Check Results (Dcrumolily) ` As of 7"" N- d'_ _, n`a search of fhe pro Tided name and date of birth revealed; b No Iowa Criminal IlistoiyRecord found with DCT Ilowa.CrlminalMatozyRecord at(ached,M1 �f 0A.. .. e ))CYinifialS_ S Received Time7"Jul."11.1(2012 2:54PM No.9784 J, 1. 18. 2012 9:46AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00414149 NON CONVICTION PAGE 1 OF 1 DATE PRINTED - 2012/07/18 DCI:00414149 NAME; CRAIG,RSATHEL DIANE DOE SEX RAC HGT WGT EYE HAIR SICU POE 19750724 P W 506 215 GRN BLN FAR IA ADDITIONAL IDENTIFIERS SC ABDOM SC L HND SC R HND TAT R WEB CCH RECORD w** 01 ARRESTED 19901003 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 XA STATUTE IA124-401(5) POSE SCH I - MARIJUANA TRICd: 044561501 COURT DISPOSITION AGENCY: XA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-401-5 POSE CONTR SUBSTANCE SCHEDULE I -MARIJUANA CHARGE CLASS: NON CONVICTION TRK#: 044561501 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19901223 COURT COSTS 19981223 PROBATION lY 19981223 DISCHARGED FROM 20010205 DEFERRED JUDGEMENT 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 FXNGERPRINTS 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.4234 P. 3 Jul.18. 2012 9:46AM Div of Criminal Investigation No.4234 P. 2 •J'o ,v. I. [Vlr t:»rty t,IIY (,sere _ (,I fY or IoIva It No. 2598 P. 2/4 1I• LV 12 J•JI'�•� J V' 1111 U I L Y V U I L I ,V I I Y' IU 1- J I o tr d `1, IV t �Y OJ. A n P.• , I `� ��rt STAU OF IOWA Ckfinfilal lftsforY1 ReqtxegtFojm TO; XoftDCv)slonofCrltnlnalYn'vesllgatlor SIlpPol'EOpera(IonaDgYoau, ft0loov 215 Street )os1VL0111es,Sorva 509x9 ��rY (610)'1--6066 (SIO) IM --6060 Fox � � % 101 AVO YIN R H . RE UE T q PLE C UHN 18 FORM o-) I aq I DCTAccountNpinber,, L/daa.—r— (ICeppll"ble) ]horn: CXTX OFIOWA a,xy t-`i'xiC C7.ERlZ'S O�UXC� Oxo 1, WAS}71NG2OIiST$LLT -IOWA CITY IOWA, 0240 Yhonaf 3);914356-5041 >7aK; 5X -966.5497 Umnlo I Temnla I _48 -� — 'a� f(WeY111fa17M'71Ol'1:Wtheutasignedwalvm,kam1)(oSnb,(oetoftherof1tres(,acompleYoorlminalhtstoryI'mcordrnaynot ho i;elensable, per Cob orlown, Chnpt0Y 692,2. Tor C6 1 crlrn!aal h(9tohyymord lllforMAllon, rlS allowed 6y)axv, n10.'ayn e D Iain a waiver stilAiLtre ]font the 9AWt of fho reauacl: 'r R�Ye1',RBlerIS2: T 6crobyglvo ptmtissian for Iho cboYo reqursling o11(61a((o Londucf ut iotre et(mhtnl hisloryrecord otlukvdlA (heDivlslon ot'pfm(na( 1�1o<rlAol(ah(UCI), MyufmllPl(ds(oryda(acoar�mlll rolhefiAm9inlelnedby(hopClnraybeYelaorcdassllavedbylety, )4rirPver.�lrg�rrU1J'e:� •• •r ; As ng �g?_ � asanrolio�fhaT»ovJdednalnoalzddafao£6irkii>otrealed; 0 M XOWA Found I�dQtbox Xo�vteCrimina(I15totyStecocdaStaoltecT,)aCX#'7�1�q bCI eceived Time ,Ju). 17. 2012 �:54PM No, 9 .. ...., ..