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Home My WebLink About12-188y4jiS I r , III h CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 5224P-1826 35 -5040 9/Z3 (319) 356-5497 FAX 1. Name 2. Mailing Authorization Number / r_— % o b (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 q/3"973-a86a Other: 4. Prior experience in transportation of passengers: Va 0l (7 C11,/SrZ92 Naze A 4u� C,B 3 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 6. Have you been convicted of years? Z,0 Type of Offense M a motor vehicle while under the influence of alcohol or drugs in the last five Where When Have you been convicted of any traffic offenses in the last five years? Type of offense Where When Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When 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) der axiddvbaag 06/2012 her ce[�I that I v Issued to me by the Iowa Department of Transportation a valid Chauffeurs license number IC C� . 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�yr vls.ons of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date ###4#i#i######4*####**R*tRRH*ft1R#1R##f###i#'Y##Y##Y###4#R#RR#**#R*tt#RittfR4iRRfitfffffff#fffifftf#NMYY#Y#######*#f#MM*###fffftfiffffft111Y# STATE OF IOWA ) COUNTY OF JOHNSON ) Xmbscribed,and sworn to before) m2 by Lew -c% 1 On this day of �W44 KELLIE K. TUTTLE Notary Public in and for the State of Iowa _ % eewniieeien Ale My 60T*issioh Expires 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 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. *#*#!!1!!1411lHI1N1fN#Yff##+****1!lf1144f1fffllffflfY#1!i#+***#4****++*ff41**1#1#f!f#lflflflllflfflfflffYf#Y#++**###+*ff+iflllHflffffY'Ff###* Office Use Only Approved application DCI report State certified driving record Website update clan jdrivbatlgeaW2010.tl 06/2012 /!� Iowa Department of Transportation �I , Office of Driver Services (Toll Free) WO -532-1121 PO Box 9204, Des Moines, lA 50305 92Q4 515-244-9324 FAX: 515-239-1337 Certified Abstract of Driving Record Inquiry Date: 8/31/2012 DL/ID #: 152CC6052 Customer #: 1782852 Name: Levell, Stacy James Class: 0 ID Status: SUR Address: 203 E 3RD ST Audit #: 1526052 DL Status: None 52 IA Issue Date: 06/15/2006 CDL Status: None City/State: WEST LIBERTY, ]A Expiration Date: 06/15/2011 CDL Cert Status: None IA 527761403 Suspended 12/10/2007 02/13/2011 D53 Non -Payment of Iowa Fine Endorsements: None CDL Med Status: None Mailing Address: 203 E 3RD ST Restrictions: None Restriction None Suspended 11/04/2011 Date of Birth: 2/27/1973 Supplement: Fine Mailing City/State: WEST LIBERTY, IA Sex: M 527761403 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/29/2005 _ 07/11/2005 'No Insurance Card 52 IA 03/01/2006 03/31/2006 B20 Driving While Suspended, Denied, Cancelled, Revoked 52 IA 07/26/2007 06/16/2009 B20 Driving While Suspended, Denied, Cancelled, Revoked 52 IA Sanctions Type_ _ Effective __ End ACD Explanation Occurrence JUR JUR Suspended 10/17/2005 02/14/2011 D53 _ Non -Payment of Iowa Fine IA IA Suspended 11/09/2005 02/14/2011 D53 Non -Payment of Iowa Fine IA Suspended 04/19/2007 02/14/2011 D53 Non -Payment of Iowa Fine IA IA Suspended 12/10/2007 02/13/2011 D53 Non -Payment of Iowa Fine IA IA Suspended _.12/10/2007 .02/13/2011 D53 Non -Payment of Iowa Fine IA IA Suspended 11/04/2011 08/30/2012 D53 Non -Payment of Iowa Fine IA IA Name: Levell, Stacy lames DL/ID: 152CC6052 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 8/31/2012 IOWA0. ff �•; r'"••••" gam_ ORNEB_;= Office of Driver Services Iowa Department of Transportation Name: Level], Stacy James DL/ID: 152CC6052 TIME: 15:23:83 4 h LEVELL STAGY JAME5w ? r F •' 215 SCHIY,BER ST< BUFFALO <^'.i NY>1420r6 \ NAME ON LICENSE/ID::% .LEVELL RESTRICTIONS: LICENSE CLASS: *E* ******************** RECIPROCITY ON:w04/0 CLASS CHANGE '05117/ DOB HEIGHT �6-( Total Fee Paid -^$10•.'00a `-/, � � / Yy OFFICE AMH =e�3 i ;r CLIENT' -ID# 231823798 7/1973', X ;Mr , EYE:.COLOR . �, GREEN 95 22184 701503: r % rP EXPIRATION 02/27/2016 u ! . r `:�> ttI•' r� */` .END OF RECORD�4y**3- + `a r e c 4 Y { \> i r 1 sr t { Fsj n Ti�''.,� .✓'., rT,.wxJifg�i'�i �� Sb ! t i r IV r IF C 'his is to certify that this docutiient is a true and�domplete copy of an electronic record on fife iR;the New York State Department of lotor Vehicles, Albany, New ibWThe record was `made in regular course of New York Stat' ., e`partment of Motor Vehicles daily usiness. It is the business of the°New York State Department of Motor Vehicles tocreate "and.`maintain the records of drivers in the tate of New York. Entries in this document are madeat the time the recorded transactions or events took place or within a reasonable me thereafter. The person who reports the information is under a business dutytd'do so accurately. nes : fwmi COUNTY: i MES Total Fee Paid -^$10•.'00a `-/, � � / Yy OFFICE AMH =e�3 i ;r CLIENT' -ID# 231823798 7/1973', X ;Mr , EYE:.COLOR . �, GREEN 95 22184 701503: r % rP EXPIRATION 02/27/2016 u ! . r `:�> ttI•' r� */` .END OF RECORD�4y**3- + `a r e c 4 Y { \> i r 1 sr t { Fsj n Ti�''.,� .✓'., rT,.wxJifg�i'�i �� Sb ! t i r IV r IF C 'his is to certify that this docutiient is a true and�domplete copy of an electronic record on fife iR;the New York State Department of lotor Vehicles, Albany, New ibWThe record was `made in regular course of New York Stat' ., e`partment of Motor Vehicles daily usiness. It is the business of the°New York State Department of Motor Vehicles tocreate "and.`maintain the records of drivers in the tate of New York. Entries in this document are madeat the time the recorded transactions or events took place or within a reasonable me thereafter. The person who reports the information is under a business dutytd'do so accurately. nes : fwmi Aug.24. 2012 3:07PM Div of Criminal Investigation Aug. Il. (OIL I:Wm Glty Clerk - City of loira City No. 0863 P. 4 No.2734 P. 2/2 STATE OF IOWA — — Criminal Mg torcy Record CheckRequest Form DCX Account2�1'Iunber: I W� (IreppIICable) TO: Iowa Division a£Criminal Inveatlgation Support Operatlobs Bureau, l'hlloor 215 E.1rh Streer Deg Moines, Iowa 50319 (815) 725.6066 (515) 725.6000 Fait l From., CITY OF IOWA CITY CITY erERX',S OFFICE 410 E. WASHINGTON STIREn IOWA CITY IOWA 52240 Phone. 3x9-356-5041 F'ax: 3.19.356.5497 Name waiveylttrormation., without a signed walyer kom the subject of tho request, a compieto criminal hfatory record may not Do releasable, per Code of Iowa, Chapter 692.2. For completq criminalhistory record Information, as allowed bylaw, always WRhVeN.Re%RSe;lbue6ygivepenn(st(oilfor (hhaGova roqucstingoffic(el(ocondu IOWflGfhhL(� l3lh(8[OlyG rdchukwi(h(hcDlvlslonotC7imine( Investl®hllon(DC9..Any Utrolhalhis(aryda(a concom(nsme(bet Ismdn(hined by o lay herelrosed as al�u} hylnw. WaiWi-Skiialti 'e; bo a Criminal HistorRecord Check Regults Ag of g a awroh of the provided name and date of birth rovealed: ® No Iowa (liminal Histoxy Record found with D CI Iowa Criminal History Record attaohed, DCI #-%?5:M DCI eceived Timr Auv 17 11111 1•60PM M,. 1616 - - �,; to .a, a f Ca Aug.24. 2012 3:07PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00465143 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2012/08/24 DCI :00465143 NAME: LEVELL,STACY JAMES DOB SEX RAC MGT WGT EYE HAIR SKU POS 19730227 M W 601 320 GRN BRO LGT IA ADDITIONAL IDENTIFIERS TAT BACK TAT L ARM TAT L CALF TAT L HND TAT L LEG TAT R ARM TAT R CALF TAT R LEG TAT UL ARM TAT UR ARM CCH RECORD *** 01 ARRESTED 19930017 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA713-1 -4-BURGLARY 3RD TRK#: 001695801 COURT DISPOSITION AGENCY: IA0520ISJ JOHNSON CO DIST COURT COUNT NO- 01 -3-BURGLARY 3RD COURT CASE ID: 33535E-1 TRK#: 007695001 RESTITUTION SENTENCE DEFERRED JUDGEMENT COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 BURGLARY 3RD TRK#: 00769SS02 RESTITUTION SENTENCE DEFERRED JUDGEMENT 02 ARRESTED 20060331 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A SCH I CONTROLLED SUBSTANCE TRK#: 101025101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT • COUNT NO- 01 IA STATUTE IA124.414 DISP EFF DAT 19940121 DISP EFF DAT 19940124 No.0863 P. 5 k g.24, 2012 3:08PM Div of Criminal Investigation POSSESSION OF DRUG PARAPHERNALIA COURT CASE ID: 06521 SRCR075276 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101025101 SENTENCE FINE $250 DCI 00465143 PAGE 2 OF 2 DISP EFF DAT 20060531 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 BASED ON INFORMATION PURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION =11dx��Q