The URL can be used to link to this page

Home My WebLink About12-147�► + 6014a CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-SO40 (319) 356-5497 FAX 1. Name 2. Mailing Address _ 3. Telephone: Home 4. Prior experience in transportation of passengers: Authorization Number, /a - / lfI (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) Other: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? T ype of offense 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?I, Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Tvpe of offense P;'. Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? �Ua. Type of offense Where When 9. Have yoever 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) ienrtaarm�a9 09/2010 I hereby certify !Vave have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number CCU4 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 ) S scribed and sworn to before me by y 0—"x— e-- t+5_V\_ . On this 3 day of Pi ihIic in nnrd fnr the Rtatp of Inwa My 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 D to 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 deM idrve dg aWM10d 09/2010 Iowa Department of Transportation Office of Driver Services (Toll Free) 800-532-1121 FO Box 9204, Des Moines, IA 503W9204 515-244-9124 FAX: 515-239-1837 Inquiry Date: 7/26/2012 Name: Shelton, Brian Andrew Address: 226 S LUCAS ST APT 1 City/State: IOWA CITY, IA 522405153 Mailing Address: 226 S LUCAS ST APT 1 Mailing City/State: IOWA CITY, IA 522405153 vunvicdons Certified Abstract of Driving Record DL/ID #: 237CCO864 (IA) Customer #: 4637966 Class: D ID Status: EXP Audit #: 6004564 DL Status: VAL Issue Date: 05/24/2012 CDL Status: VAL Expiration Date: 03/18/2015 CDL Cert Status: Excepted Intrastate Endorsements: 3 CDL Med Status: None Restrictions: Commercial Instruction Restriction CDL Instruction Permit Suspended Permit, Corrective Lenses Supplement: Expires 11/24/2012 Date of Birth: 3/18/1983 IA 09/21/2002 Sex: M Driving While Suspended History Information Citation Date Conviction Date ACD Explanation ACD Explanation Occurrence 7UR County 7UR 06/06/2002 ._..._ _rj07/03/2002 _ _020 Driving While Suspended, Denied, Cancelled, Revoked _.. X52 TA 08/18/2002 �09/OS/2002 B20 Driving. While Suspended, Denied, Cancelled, Revoked 52 IA 08/20/2002 109/16/2002 Suspended Driving While Suspended Dented, Cancelled, Revoked .52 IA 09/21/2002 10/29/2002 +B20 B20 _ Driving While Suspended Denied_, Cancelled, Revoked 52 SIA , �IA 09/21/2002 10/29/2002 Habitual Offender No Insurance Card Suspended _ _ _ 52 B26 09/25/2002 311/06/2002 B20,y _ Suspended Suspended Denied Cancelled,_Revoked D38 _ 57 - IA y 02/03/2003 09/09/2003 ........ Y02/22/2003 ...DrlvingmWhile No Insurance Card _ .52 .. �.,?A -_, 02/03/2003 ,'08/01/2008 N63 Drivin11.g Wrong Way on_One Way Street 'IA 52 •IA 03/14/2003 :09/09_/2003 07/21/2003mmW B21 .Driving. While Barred ....,..... _ _ _ _ _ _ _ ..._.._...._µ 52 mw . IA .,.. 06/07/2010 µ r..............................rivi....... ;07/05/2010 S92 •Speed _B.. ..IA.. Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 3UR 09/25/2002 12052336 IA Sanctions Effective End ACD Explanation Occurrence 7UR ]UR Suspended ,04/20/20 02 S93 :Serious Violation =IA ..,,, Suspended .01/30/2002 104/15/2002 09/08/2007 'D53 .Non Payment of Iowa Fine .; ... .._ .....__ ___.. __...... .. .,IA ...... Suspended '04/22/2002 108/02/2008 D53 _Non Payment of Iowa Fine -_ .. _.... IA Suspended 108/26/2002 11/24/2002 W01 ,Habitual Violator IA _ ,IA Suspended usp '10/29/2002 101/17/2003 D27 .....>_ Violation of Probation ._._.. ..... ... ......... ...... IA ... ,IA . Barred ,. .... 11/07/2002 111106/2004 WOS Habitual Offender .IA TA- 111. Suspended X11/24/2002 02/22/2003 B26 _.Driving While Suspended Denied, Cancelled, Revoked IA IA _ Suspended 12/30/2002 '09/25/2003 D38 'Fail to Post Security for Accident .......... ..._. .. IA .... JA _. Suspended ........ Y02/22/2003 I 05/23/2003 B26 _.;. While Suspended Denied Cancelled, Revoked _ :IA Suspended 02/25/2003 ,'08/01/2008 __Drlving D53:Non Payment of Iowa Fine ,IA 'IA Suspended _....... _03/24/2003 _ 101/28/2030 D53 'Non-Payment of Iowa Fine 7/26/2012 �Iq Suspended _ _._. .04/17/2003 _...._ _ ... "01/28/2010 _ ... _ D53 _ .._ .__. Non-Payment of Iowa _ _. _ ._ ._.. _ _. .. Fine ... e-. ... .. ... LIA ...... _..5._.,.... lIA Suspended _ 06/20/2003 01/28/2010 D53 _ Non-Payment of Iowa Fine _ _ 'IA SIA Suspended ,07/04/2003 01/28/2010 D53 Non-Payment of Iowa Fine IA ;IA Suspended _ '08/19/2003 01/26/2010 D53 Non-Payment of Iowa Fine IA 'IA Suspended 09/03/2003 12/02/2003 D27 Violation of Probation -IA SIA Suspended '10/31/2003 01/29/2004 D27 'Violation of Probation _ _ _ IA QA Suspended ,12/15/2003 107/30/2008 D53 Non-Payment of Iowa Fine 'IA IA Suspended .02/18/2004 04/30/2006 D53 -Non-Payment of Iowa Fine _ }IA Suspended ,05/05/2004 01/21/2010 D39 Judgment Iq Name: Shelton, Brian Andrew DL/ID: 237CC0864 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: 7/26/2012 ...... . = Office of Driver Services `DRIVER_; Iowa Department of Transportation Name: Shelton, Brian Andrew DL/ID: 237CC0864 �a. Ju1.31. 2012 4:15PM Div of Criminal Investigation JV1.3U. 1UIl 11: MI City Clerk - City of Iowa City i STATE1. Record Check 4,I.j 10{'lA� l¢RWI�� To:rewaDlvlslonofCrlminalSavestlgation Support Operaflass Bureau, I"1?100r 215 LC, 71h Street Drs Ivfolnes, Iowa 50319 (515) M-6066 (515) 726-6080 Fast IOLD re estin anlowa0-inillialliisto 'Record Check x.raANaiae(mandatoty) I Mrst Nalno No -6462 P. 5/15 No. 2642 P. 2 DOIAccount Number, 4(.I --r— (ifopplieeble) From; CITY OF JOWA CITi CITY CLIMIC'S OFFICE 4101;, WASIIMOTOh1STRELx IOWACITY XOWA 52240 Rhone; 319-356-9041. )VPX; 319356-5497 4ale QFemalo A— 60,—I)T l� Walvep,(ryfortnafiorR Wfthou( a signed waiver from the subject of the request, a complete crim(nal histo►)•record may not be reloasable, per Code of iowal Chapter 692.2. Forco_ mUlefe crlmfnal h(stoty record Information, as allowed by law, always nhta In n ava lvnv a.,..., A- -.a 1... -4.1 - '-- -'--` Waiver Aele&Se; thucby glvo pcnnissims for the ]nvcsligallon(DCQ, Any criminal hlalory data wnccmin As of Waiver official to conduct an lows criminal history record chccksvirh dr0 Division of CNminal ained by 1110 Dpi may ba Messed as allowed bviaw. v VITA 1\VO LL1LJ (DC1Uso only) a search of the pxovided name and date of With ravealed: EJ No Iowa a-iminal.l'iistory Record found With ACI �Io•Wa Criminal XTisto>:yRecord attach -cd, DCTiniiials t" ✓ 'received Time7-Ju1.'30,1(2012'1'1'57AM No. 0424 Jul. 31. 2012 4:16I'M Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00693657 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2012/07/31 DCI:00693657 ' NAME: SHRLTON,BRIAN ANDREW DOB SEX RAC HOT WGT EYE HAIR ST07 POB 19830318 M B 510 230 BRO BLK MBR IN ADDITIONAL IDENTIFIERS PHOTO AVAILADLE: Y SC R SHLD CCH RECORD *** 01 ARRESTED 20030314 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321-561 DRIVING WHILE BARRED TRK#: 100813401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06521 AGCROG4955 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100813401 SENTENCE DISP EFF DAT JAIL 9D 20030721 FINE $500 20030721 02 ARRESTED 20070213 No.6462 P. 6/15 AGENCY; IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708.2(2) ASSAULT CAUSING BODILY INJURY -1978 TRK#: IA000U401 COURT DISPOSITION AOENCY: IA052015J JOHNSON CO DIST COURT COUNT 140- 01 IA STATUTE IA708.2A(2)(B) DOMESTIC ABUSE ASSAULT WITHOUT INTENT CAUSING INJURY COURT CASE ID: 06521 SRCR077844 TRK#: IA000U401 SENTENCE DISP EFF DAT APPEAL DATE DEFERRED JUDGEMENT 20070529 PROBATION lY 20070529 20071129 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY B$ 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