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Home My WebLink About12-161l � CITY OF IOWA CITY 410 East Washington Street Iowa CitY- — Iowa 52240-1826 - (319) 356-5040 �13-155}356-5497 FAX 1. Name 2. Mailing Authorization Number (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) 3. Telephone: Home 4. Prior experience in transportation of passengers: Other: S/9 473d 61&36 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? GS Type 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? ri0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Le S Type of offense Where When 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? /✓ d Tvoe 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) derWYatidrivbadg 09/2010 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's licjnse number �p /</ &1Ltl 6AC, / 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 pr isions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) n /7 �, � Signature of C STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by Date k-10 -/Z On this Ile day of in and for the State of Iowa Li 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 Chief or designee �� - Signa of City Clerk or designee f -Jd-/ Z 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. Office Use Only Approved application ✓- DCI report State certified driving record v Website update ✓ deRtt jd ivbadgma 2010 doc 09/2010 Au. 9. 2012 4:19PM Aug. 3, 2012 12:23PM Div of Criminal Investigation City Clerk - City of Iowa City STATE OF IOWA (ciriminal Mstory Record Check Request Form To: Iowa D1V191e11 of Criminal Investlgattoa Support operatlons Burcau, l`IFloor 215Y, 7'a Street Des Idolnes, Iowa 50319 (515)729.6066 (515)725.6000 Fax I am f! r%?' Q L(d��c No.8240 P. 24/30 No, 2668 P. 2 DCIArcountNnmber: `T` op- -r (Ifapplirvbls) Frons: CITYOFIOWA,CITY CITY CDF'Rxls OFFICE 410 E. WAs11Ir7G ON ST1t kET IOWA CITY IOWA 52240 pyrone: 319-356-5041 Iraxl 319356-9497 [ ale UFomale -- r— rml[t(oH: WithoutasignedWaiver from thosab]octOfthe request,acomplete criminalbisioryr•ecordMay not per Code of Iowa, Chapter 692.2• Foror�mnlete criminal history record Information, as allowed by law, always obTam a waiver sr nawro,runs u.cauu v... ••. •••...� WaillarRejeaSe:Illerebygivepemdssionfbrrheeb v requeslingoaiolellbconduet wacriminal ha(cry recordcllc*wahtheDivisi011OfCrimtnai Jnyesngailon(DCI). Mycsiminalhistorydata concarnin> nt merned�+�IheUCI 1 bC;owed as allowedhylaw. Waiver Iowa Criminal 'stor Record. Check tcesults (Dcrasaonly) a search of the provided name and date of birth revealed: -� f x < As of rn'�� I '�(•n No Iowa Criminal History Record found with D C1 ;r -o cn �z Iowa Criminal history Record attached, DC1# b� I (� j, W DCT initials Aug, 9. 2012 4:19PM Div of Criminal Investigation No.8240 P. 25/30 r IOWA CRIMINAL HISTORY DCT 00269969 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED- 2012/OB/09 DCI:00269969 NAME: WYLIE,LLOYD EUGENE SKN POB DOB SEX RAC HGT WGT EYE HAIR 19581124 M w511 200 HAZ GRY FAA IA 19581224 ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT L FGR TAT L SHLD TAT R SHLD TAT UR ARM CCH RECORD 01 ARRESTED 19801101 AGENCY: IAD820000 SCOTT AT CO SO IA70B-2 CHARGE NO- 01 ASSAULT INTENT SERIOUS INJURY TRK#: L18147001 COURT DISP05IT10N AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 01 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L18747001 SENTENCE PLEAD GUILTY FINE $100 02 ARRESTED 19810708 AGENCY: IA0820000 SCOTT CO SO CHARGE NO- 01 BURGLARY 2ND DEGREE TRK#: L1B747101 COURT DISPOSITION AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 01 BURGLARY 2ND DEGREE CHARGE CLASS: NON CONVICTION TRK#: L18747101 SENTENCE DEFERRED JUDGEMENT DISCHARGED FROM DEFERRED JUDGEMENT PROBATION 2Y CUSTODY AGENCY: IA077015G ADULT PAROLE SVC A PROBATION CUSTODY AGENCY: IA077015G ADULT PAROLE SVC B 19031021 DISP EFF DAT 198D1230 19801230 DISP EFF DAT 19811021 19831010 Aug. 9. 2012 4:20PM Div of Criminal Investigation DISCHARGED FROM CRIMINAL JUSTICE SYSTEM 03 ARRESTED ' 19830420 AGENCY: IA0820200 CHARGE NO- 01 owl TRK#: L18747201 COURT DISPOSITION DAVENPORT PD IA STATUTE IA321-281 AGENCY: IA062015J SCOTT CO DIST COURT COUNT NO- 01 IA STATUTE IA321.281(A)-2 OPERATE WHILE UNDER INFLUENCE 1ST OFFENSE - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1,18747201 SENTENCE PLEAD GUILTY SUSPENDED JAIL FINE 04 ARRESTED 20030805 AGENCY: IA0820000 CHARGE NO- 01 OWI 18T OFFENSE TRK#: 902542801 COURT DISPOSITION 7D $400 SCOTT CO SO IA STATUTE IA321J.2(2 A) AGENCY: IA062015J SCOTT CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VEN WH INT (OWI) / IST OFFENSE COURT CASE ID: 07821 OWCR261507 TRK#: 902542801 SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT lY PROBATION lY 05 ARRESTED 20120220 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: 1A00DQ301 DCI 00269969 PAGE 2 OF 3 DISP EFF DAT 19840103 19840103 19840103 bISP EFF DAT 20031008 2003/008 No.8240 P. 26/30 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 THISD is BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT T ECORD COVERS THE SUBJECT OF YOUR INQUIRY. Aug. 9. 2012 4:20PM Div of Criminal Investigation DIVISION OF CRIMINAL INVESTIGATION No.8240 P. 27/30 A Iowa Department of Transportation Office of Driver Services (Toll Free) 8051-532-1125 PO Box 9204, Des Maines, to 50305-9204 515-244-91244 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/3/2012 DL/ID #: 614WWO391(IA) Customer #: 3413755 Name: Wylie, Lloyd Eugene Class: D ID Status: None Address: 1670 5TH ST APT 6 Audit #: 5472372 DL Status: VAL Issue Date: 08/26/2011 CDL Status: None City/State: CORALVILLE, IA 522411859 Expiration Date: 11/24/2014 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 1670 5TH ST APT 6 Restrictions: NONE Restriction None Date of Birth: 11/24/1958 Supplement: Mailing City/State: CORALVILLE, IA 522411859 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 08/05/2003 10/08/2003 A20 Operating While Intoxicated 82 IA 01/23/2009 '02/24/2009 N01 Fail to Yield Right of Way _ 23 IA 03/18/2009 05/13/2009 _ _ Speed (10 mph & under in 35-55 mph zone) 57 _ IA 01/22/2012 102/16/2012 •M14 Fail to Obey Traffic Sign/Signal 52 ,IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation SUR 08/05/2003 A98 OWI Test Failure IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 3UR 01/23/2009 _ 488468 "IA 09/09/2011 646575 IA 02/17/2012 673583 IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked 08/16/2003 02/12/2004 A98 OWI Test Failure IA ',IA Suspended 09/24/2008 ;10/22/2008 D39 Judgment IA IA Suspended 09/06/2009 x.09/29/2009 863 Fail to Refile SR22 IA IA Name: Wylie, Lloyd Eugene DL/ID: 614WWO391 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: sew% VIICIf p/may Name: Wylie, Lloyd Eugene DL/ID: 614WW0391 6/3/2012 C41W 0"A Office of Driver Services Iowa Department of Transportation