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Home My WebLink About12-140aT X 11 1 CITY OF IOWA CITY 410 East Washington Street � 3y� 356-504 (319) 356-5497 FAX 1. Name Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 2. Mailing Address Z87q ;p1e 3. Telephone: Home 7L.7- 2:26 377'i 4. Prior experience in transportation of passengers: Anz 51 f I :10, C Other: Last 'c�__/C D (Office Use Only) 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Tvpe of offense C,Myb5t ,,e t94 Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? /(%o Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A Tvpe of offense Where When 9. Have you ever applied to bean 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) dwWtazidnvbadg 6Qi�B40 °b12o1'� hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 7 5 3 MM g�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 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 Applicant Date STATE OF IOWA ) COUNTY OF JOHNSON ) fro i Y A SGl Lt.P-fZ 2,4S-. 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). ate 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 derb idnvbadgeapp=O.doc 09/2W � 6120 11 Iowa department of Transportation Office of Driver Sefvices (Tell Free) BM -532-1121 PO Box 9204, Des Moines, 1A 5(1306-92(14 515-244-9124 FAX: 515-239-1637 Inquiry Date: 7/18/2012 Name: Schuetz, Kevin Eugene Address: 2874 TRIPLE CROWN LN CDL Status: UNIT 1 City/State: IOWA CITY, IA 522407228 Mailing Address: 2874 TRIPLE CROWN LN UNIT 1 Mailing City/State: IOWA CITY, IA 522407228 Convictions Certified Abstract of Driving Record DL/ID #: 753MM0999 (IA) Class: D Audit #: 6134497 Issue Date: 07/18/2012 Expiration Date: 06/11/2017 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 6/11/1977 Sex: M History Information Customer #: 5033602 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Citation Date Conviction Date ACD Explanation County 7UR 10/16/2001 111/29/2001 ,A20 (Operating While Intoxicated <52 :IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation 7UR _...._ ........... i........._..._ ._ .... .. _ _ ........... .......... 10/16/2001 jA90 ;OWI Test Failure IA Sanctions Type Effective_ End ACD Explanation Occurrence 7UR 7UR Revoked 10/27/2001 :04/25/2002 m tl!A90 `OWI Test Failure ._ IA a.__....�_..�............_,._ ....�... 'JAS Name: Schuetz, Kevin Eugene DL/ID: 753MM0999 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: ••••••' .7i-" 7/18/2012 IOWA' D. 0. T..".44 fF �Al�g- Office of Driver Services aBill Iowa Department of Transportation Name: Schuetz, Kevin Eugene DL/ID: 753MM0999 V Jul.23. 2012 9:39AM Div of Criminal Investigation 'LYx■ v. Lull 1-1l n ttty vlefa - t,lty of Iowa 1,Ity i'.o``IA�°J`STATE OF IOWA '�/r'JL1 wr`Criminal Record `' �t110V1A � 1 1 1: i \.acq' Request 1 1 To: Iowa blvlalon of CriminalXnvestigatlon Support Operationsl3uroqu,1"Floor 215 E. 71A Street DesMotnesjavva 50319 (515) 77x5.6066 (515) 725-6080 fax X ant requesting an Iowa Criminal HlstoryRecord Cheek Olt; No. 4911 P. 1 No. 'Lbub P. 2 DCI Account Wumber: 7 w� (i�appliu+blc) from: CITY OP IOWA CITY CITY CURRYS OFFICE 410 V. WASIMGTOWST.RIMT IOWA CITY IOWA 52240 Phone: 319-356-5041 Vax: 319-356-5497 LutName (mandmo First Name, mandatory Middle recommende /G11 ✓Gl T� Pd; j e7 E ))ate of Birth (mandmory) Gender (mandatory) Social Security Number recommended) ale ElFemale $7—��'S z yi WaiyePTfffarmailan: Wif1tout n signed waiver from thesubJect of (Ite request, a complete eriplinal history record mnynot bo releasable, per Codo otlown, Chapter692, 2. for comnlofe cl lmtnal history 1'ccord Information, a5 elicited bylaw, always obtgln n waiversienataro n•om thesublectof the request. Waiv9PRelarlse:7hereby glvopemdsslonIbrrheaboverequestingofficlaltoconduct a Iowa crrmlaallibloryrecordcheckW1111theDivisfmloEcrlmrnel Invcrllga0on(DC0. Any criminal blslotyda(aconccminpmoOath maintained byihobClmayboreleasedmollowcdbylmv. Waiver Signature: Sowa Criminal History )Record Check Results (DC[uso only) As of AQ I Va search of tho provided name and date of birth rovealed: No Iowa Criminal History Record found with DCL r Iowa Criminal History Record attached, DCL 1]CXiriltialS received I'1-- 77 j$;1C2012 4:46PM No. 9918 Jul.23. 2012 9:39AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00604412 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRI4TED- DCI:00604412 2012/07/23 NAME: SCHUETZ,1ZEVIN SCHUETZ,KEVIN EUGENE DOB SEX RAC HGT WGT EYE HAIR SKN POB 19770611 M W 602 230 BRO BRO LGT IA ADDITIONAL IDENTIFIERS CCH RECORD •�• 01 ARRESTED 19990623 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401-5 POSS CONT SUBS I TRK#: 046841961 COURT DISPOSITION AGENCY: IA05201SU JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(5) POSSESS SCH I CONTROLLED SUBSTANCE -MARIJUANA COURT CASE ID; SRCROE2673 CHARGE CLASS: NON CONVICTION TRK#c 046841901 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19991201 COURT COSTS 19991201 PROBATION lY 19991201 DISCHARGED FROM 20000912 DEFERRED JUDGEMENT 02 ARR99TED 20011016 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 owl TRK#: 100369301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VER WH INT (OWI) / 1ST OFF COURT CASE ID: 06521 OWCR060201 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100369301 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 20011129 FINE $1000 20011129 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 FINGERPRIN'T'S FOR POSITIVE IDENTIFICATION THIS RECORD IS No. 4911 P. 2 Ju 1. 23. 2012 9:39AM Div of Criminal Investigation BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS TRE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No. 4911 P. 3