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Home My WebLink About12-133Firs Middle Last 1. Name Ct1J,.e_r E( \f\ �Lcidnry. 2. Mailing Address l DCA E, S4 71l� X C 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: Chi J �c� \C ;� els �� •r•� Plnco 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? yf <_ Type of offense Where When Q,, C�.�c� 2nc�cr�c�y(\tia.n�c VAWq \9C � 6. Have you:leen 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? �d Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? D 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) B9li 630 tlerWlaxitlnMatlg U10 I�Lo Authorization Number % 1 (Office Use Only) 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 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX Firs Middle Last 1. Name Ct1J,.e_r E( \f\ �Lcidnry. 2. Mailing Address l DCA E, S4 71l� X C 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: Chi J �c� \C ;� els �� •r•� Plnco 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? yf <_ Type of offense Where When Q,, C�.�c� 2nc�cr�c�y(\tia.n�c VAWq \9C � 6. Have you:leen 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? �d Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? D 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) B9li 630 tlerWlaxitlnMatlg U10 I�Lo I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number (\G64d �5 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) n _ Signature of Applicant. Sr u.w�46,&) Date— #iR#iii#H#############*R**RRR*HHiftif*ii1HHf1f1#fffHHYffHfHlfffHfH1Y1HHHfflffMY1f11HHfHH*HfHlfffffHHif#iHi#####YH##HR* STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by V Qnn"Lr- L rc On this / 9 day of J u P A'*-� NDRAE FORT ICum misSOslan Number 158791 ,S223J6�� C4 My commission 3/7/UVCEO— Notary Public in and for the State of Iowa +f++H+++++++++++H++++++++++++++++++++++++++H+++++H++++H+H+++HH++++++H+++++H++++++HH++++++++++H+++++H+++H+f+H++++++++++H++++++++ 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). -�4Z4�� - Sig Ature of Police hie udesigne SignWture of City Clerk or designee ��o,.2, Date 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. *#R###*HHH*RRH+RfHH+HHfHfHYHHH.fHH1fH.ffHff.fflff lffYHHfHfH+HifHHHHY.fHHHfHHHYffHfY#iiiff Y#iHHfHifiYH####RR Office Use Only Approved application DCI report State certified driving record Website update uannawanwaagaapp2010.m 092940 0"1201-- A Iowa Department of Transportation Office of Driver Services (roll Free) 800-532-1121 PO Box 9204, Des Moines, IA 503D&9204 515-244-9124 FAX 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 3/2/2012 DL/ID 9: 960AA6911 (IA) Customer #: 2336133 Name: Quiram, Jennifer Erin Class: C ID Status: None Address: 221 32ND AVE W LOT 3A Audit #: 5599585 DL Status: VAL Issue Date: 10/28/2011 CDL Status: None City/State: SPENCER, IA 513016151 Expiration Date: 11/04/2014 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 221 32ND AVE W LOT 3A Restrictions: Corrective Lenses Restriction None Date of Birth: 11/4/1976 Supplement: Mailing City/State: SPENCER, IA 513016151 Sex: F History Information CLEAR DRIVING RECORD Name: Quiram, Jennifer Erin DL/ID: 960AA6911 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: y4 3 Qf�f Dj44 3/2/2012 IOWA ' '�; i fat D 0. T.;m •' r ' Office of Driver Services �tl*�T Iowa Department of Transportation Name: Quiram, Jennifer Erin DL/ID: 960AA6911 Jul.12, 2012' 1:48PM,1 Div of Criminal Investigation No.9527 P. 7/9 Vu 1. 11. LV 122 vu11. LII LVI �.7I n1+1J 1r IV111'I VI ty �I CIX �I ly UI IUWa k,I ly v11 VI VI 111111141 1111 Vut16u1I Vn NO. L900, IV. IVVV Y. 1. L/2 I Jun. 191 Lull Y L;girM GIty UI ark — city of Iowa Lily He. All) f. L Tat X6{ynI)IvlslonofCrltntaal7nvetigodon Support Operations Bureauss l?jool 215 E. 711, Sivact AosMohtes,Iowa 50319 (915) 726.6066 (516) 925-6080 Fax L` DO000outifwumbol': oDa (tfnppllonbla) Vrorlt: CITY OF IOWA CITY CITY CI; RX's OIIPXC)L 410 R. WASHINGTONIST)t'FLyT IOWA CITY IOWA 52240 Phohe: 319.356.5041 B'ext 319-356.5499 ( Check on: Now fnlou OM210 �Fomle Ll�gr(Z12-- t1 I�rllvePJ?(for)Ndlt1nWldioutasignedwglvormrnthosubjectpff aroquos6acomplotoceitnUtalhfstoryvecordtnaynot be roleasabie,pel' Code. of 1o�ya, Chnpfer 692,2, k'or,qoin)Iia orfmiunl hfsfory roaord Ihformallon, as ellotl'ad by )aW, Nlways Wrrlverl(aleasef Ih1n6y sive pbmdtriott for ilia ADVO regl(011ds opioid to conduct ul Iowa atllttlnnl hhtoVJllc(4f4 altuk\Nlh the ))Ivhlon orcflmisel lnvaItgn[Ion (DCI). A0t'C(hhln)IMttorydo"hoamingMoIhdHhNniainc44y1110W(Fulybofetr41011rt11110wad)iyinwl Iowa CrIminaMistoxy Record Check Results As of 4' U� I; , a searoh of the provldcd namo and date of bltth ievea(ed: IAVO El No IowaCyiminalEfstoryRecord fomidwithEICI T� IS pc, Iowaorinllnal IlisloryRcoord attached, DOI# bCTinitials___�Grw" �y�� Received Timel.Jul, 11; 02012 9:42AM No. 9397 Jul..12, 2012, 1:48PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00580572 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2012/07/12 DCI:00588572 NAME: HILLER,JENNIFER GRIN LASCRKE,JENNIFER ERIN DOE SEX RAC HOT WGT EYE HAIR SKN POB 19761104 F W 505 400 BRO BRO FAR IA ADDITIONAL IDENTIFIERS SC R EYE TAT L SHLD CCH RECORD •** 01 ARRESTRD 19901210 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA726-6-1A CHILD ENDANGERMENT TRK#: 044586501, CHARGE NO- 02 IA STATUTE IA716-6 CHILD ENDANGERMENT TRK#: 044586502 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA726-6(3) CHILD ENDANGERMENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 044586501 SENTENCE DISP EFF DAT SUSPENDED JAIL 83D 19991022 JAIL 90D 19991022 FINE $500 19991022 COURT COSTS 19991022 PROBATION 2Y 19991022 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA726-6(3) CHILD ENDANGERMENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 044586502 SENTENCE DISP EFF DAT SUSPENDED JAIL 03D 19991022 JAIL 90D 19991022 FINE $500 19991022 CONCURRENT WITH COUNT 01 19991022 COURT COSTS 19991022 PROBATION 2Y 19991022 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY TH i7A DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION I PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI, No.9527 P. 8/9 Jul.,12, 2012' 1:48PM Div of Criminal Investigation No.9527 P. 9/9 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