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Home My WebLink About12-142It _0 = - +. Mlw®ill CITY OF IOWA CITY 410 East Washington Street Iowa Cit 2240-1826 3S6 -S040 t$y\ (319)356-5497 FAX First 1. Name Authorization Number !a - /44a (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) Middle � lei Last K I �11� C I 2. Mailing Address IW,S Vb(- 4*I57I 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: Gc(�\ i�)rtuc_,r' (", oc 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offenseWhere 4a Uv�I�e �o( 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Tvpe of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? '\/If S 8. Has your driver's license or Type of offense When Whe W(r� p�551((ZC�ereCl J`kcCo Q0 S n license been suspended or revoked in the last five years? 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) Gerw iorivbadg 09/2010 I hereby cert' that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number (9 \/ \ / %_� c(� . I understand that if I falsely answer any questions in this application, that this application may be dei . 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 tl rovisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date_2 STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me b 1 VSP rn ✓; k: On this � day of SONDRAE FORT `` Commission Number 159761 may[ •I My CorFmis�on E>�Ye� I o 3 z/ 9 5 Notary Public in and for the State of Iowa 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). Signature of Police G of or designee T . '��/ Signature of City Clerk or designee G Date %- 14 -- 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. Office Use Only Approved application DCI report State certified driving record Website update 6erFnsvNiwedgeepp201 0. a a 09/2010 • Jun, 28. 201211 4:32PK Div of Criminal Investigation v u l 1. L V. L v, 2 7, V W Aa1 V I t y V I e I K b l l y e I I U W a V l l y Y STATE OF IOWA Criminal History Record ChecIr Request Form 'To; Iowapivislon of Criminal Investigation Support Operations 13urean, I" Floor 216 E, 7h Street Des Moines, Town 50319 (515) 725-6066 (515) 725-6090 Fax Ian, rratluesting an Iowa Criminal Ilistory Record Check on: No. 1194 P. 1/2 no. L400 r. L LL14� .nrrjr�ro . DCIAccount Number; �r--- (if applicable) From: CITY OF'IOWA CITY CITY CT,ViRX s O fck 410 X. WASTIINGTONSTKEPT IOWA. CITY IOWA $2240 Phone: 319-356-5041 Fax: 319-356.5497 Last N&)tte (mondnicp) First NAMe (tnandafory Middle Nalne (rammmcnded) (�ulV(`�� 1 I �S 1� M,,e�i� Date of Birth (mandatory) Gender (mandatory) Social Securl Number (recoo annoded) /D /G ] / F ( PMsle ❑Female 2-. Z3 2 71 1 61 I l IYaever[njOrmrt[ton, Without a signed wrl Ivor Noin the subject of the request, a complete crim (no I It (story record may not be releasable, per Code of Iowa, Chapter 692.2.)For coml�icta ciimtnal history record information, os allowed by late, al,pays obtain a walver sl>rnntare from the sub i ect of the rea «est. Waiver {release: Ihereby give pconwion for ilia above requesting onlcfal to conduct on lows crlm(nol hatory rccord cllecknddr rhe olvlsfon of Camel Inveuloellon (DCi), Any etlmlnal history, da(a concemingme that is molnlslakd by the ))Ct may bo released as allowed bylaw. Waiver SPgltature; V ' Iowa Criminal-History.Record Check, Results, (ocl=only) As of �O`� i-�� , &search of the provided name and date of birth revealed: c_ ❑ NoIowa Criminal ffistoryRecordfound with DCl •. Iowa Criminal History Recoil attached, DCI # 1-/ d q d w DCI initials Recoivoa Tima� luny^In gM19 Q•AlAM Nn_ AM 'Jun.28. 2012 4:32PM Div of Criminal lnvesti;ation IOWA CRIMINAL HISTORY DCI 00740930 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2012/06/28 13CI:00740930 NAME: MULVIHILL, JOSEPH ALLEN DOE SEX RAC HGT WGT EYE HAIR S%w POE 19811014 M W 600 185 HAZ PRO FAR VA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** No -1194 P. 2/2 01 ARRESTED 20041127 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE TA321-561 DRIVING WHILE BARRED TRK#: 053336601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321.561 DRIVING WHILE BARRED HABITUAL OPEHNDER - 1978 COURT CASE ID: 06521 AGCR070721 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 05333660/ SENTENCE DISP EFF DAT APPEAL DATE JAIL 7D 20050016 FINE $500 20050816 20060301 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 H`AON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD THE SUBJECT OF YOUR INQUIRY. DIVI ION OF CRIMINAL INVESTIGATION Iowa Department of Transportation Office of Driver Services (Toll Free) 8M-532-1121 PO Box 9204, Des Moines, IA 50396-92(14 515-244-9124 FAX: 515-239-M7 Inquiry Date: 6/20/2012 Name: Mulvihill, Joseph Allen Address: 1205 LAURA DR TRLR 151 City/State: IOWA CITY, IA 522451536 Mailing Address: 1205 LAURA DR TRLR 151 Mailing City/State: IOWA CITY, IA 522451536 Convictions Certified Abstract of Driving Record DL/ID #: 556YY2092 (IA) Class: D Audit #: 5377148 Issue Date: 07/19/2011 Expiration Date: 10/14/2014 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 10/14/1981 Sex: M History Information Customer #: 4097299 ID Status: VAL DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: .Driving While Suspended Denied, Cancelled, Revoked Citation Date Conviction Date ACD Explanation County JUR 07/30/2005 '08/18/2005 B20 Driving While Suspended Denied, Cancelled, Revoked 52 ;IA 12/25/2005 101/20/2006 B20 .Driving While Suspended Denied, Cancelled, Revoked :52 IA 10/28/2011 105/08/2012 M75 Passing School Bus -.52 >„IA 02/02/2012 104/10/2012 S92 w._ Speed (10 mph @ under in 35-55 mph zone) 157 'IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 03/18/2011 _ - 622790 'IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Barred ;03/14/2006.03/12/2009 Wol IHabltual Offender'IA:IA Suspended ,10/12/2006 1,10/11/2007 '1326 Driving While Suspended, Denied, Cancelled, Revoked _ ;IA ..._._.w.....�,.- TA - Name: Mulvihill, Joseph Allen DL/ID: 556YY2092 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: `• •:?%'4 6/20/2012 IOWA''' D. O.T.:W% F••••••' gam_=' "ftAIYE,_ Office of Driver Services a Iowa Department of Transportation Iowa City DL Station %Eastdale Mall 1700 S First Avenue Iowa City, IA 52240 Statement Receipt: 26795482 e ustomer Information Name: Mulvihill, Joseph Allen Address: 1205 LAURA DR TRLR 151 IOWA CITY, IA 522451536 Phone: Fax: Email: Attached Customers Mulvihill, Joseph Allen Transaction Office Information Date: 6/20/2012 8:43:27 AM Location: Iowa City DL Station Name Type Description Amount MISC Finance Transaction - Mulvihill, Joseph Allen $5.50 Product Amount Sale of Records - Certified $5.50 Total Due: $5.50 Payments Payment Method Payor Cash Mulvihill, Joseph Allen Payor # Number Amount Tendered 4097299 NA $5.50 Total Tendered: $5.50 Cash Back: $0.00