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Home My WebLink About12-203trtll®��Il CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name 2. Mailing Address _ Authorization Number /9 �—) O) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) Middle 3. Telephone: Home 3 1 � - 31? - 770)- Other. 4. Prior experience in transportation of passengers: r A A V eZ (Office Use Only) Last.-? /a, WC, 52,00 - 055-by6b 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? yr 5 Type of offensett �t+I,, 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? tiO Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense S o -eel Where When )!?- ;2o/.2- 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type 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) lv b 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) de,Muddwed9 06/2012 I hereb certify that I hive issued to me by the Iowa Department of Transportation a valid Chauffeurs license number i (� t H A 9 XD7 . 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) lq /1 Signature of Applicant h'! /dam Date—7- cy - % - 2 6 �z STATE OF IOWA ) COUNTY OF JOHNSON 1 S scr bed nd s Xrn to before me by r-) e �� a i f On this day of 01 Z ..;Nt . KELLle K. TUTTLE 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). 5//� 6 SigrFature of Police Wief or designee SignAmre of City Clerk or designee 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 Website update de, id7AadWp2010a 06/2012 tJSA z ODNEYE7�� -v:r et02roxTRM- OL eb ypu plC m`r.7i sc..,m�,K � Ks Q fx. v ie ti 3t l �® �0K1 �� yyt2iyi13�R1033MQ�t5R c ✓ass _Dyla 3�� -Iowa Department of Transportation LA Office of Driver Services (Tall Free) 80D-532-1121 FO Box 92114, Des Moines, 1A 50308-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/31/2012 DL/ID #: 960AA9807(IA) Customer #: 2228817 Name: Blair, Rodney Dean Class: B ID Status: None Address: 602 FOX TRL Audit #: 4223732 DL Status: VAL 52 IA Issue Date: 03/30/2010 CDL Status: VAL City/State: IOWA CITY, IA 522409209 Expiration Date: 03/05/2015 CDL Cert Status: None Endorsements: L CDL Med Status: None Mailing Address: 602 FOX TRL Restrictions: NONE Restriction None Date of Birth: 3/5/1966 Supplement: Mailing City/State: IOWA CITY, ]A 522409209 Sex: M History Information Convictions Page 1 of 2 Citation Date Conviction Date ACD Explanation County IUR 05/01/2009 ,05/18/2009 -Speed (10 mph & under In 35-55 mph zone) _ �__ ....._.. _,�......._...... :92 __!IA _......,, ,_...._ _,.,.. m. 12/08/2010 _... _ 01/03/2011 .,..«. .Improper Registration ., X52 IA 11/14/2011 12/07/2011 :S92 Speed 52 IA 01/08/2012 (02/28/2012 ;515 Speed 'IL Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident DateCase Number JUR ........ ....... .. 08/20/2007 1._ 389515 IA 09/07/2007 392736 IA Name: Blair, Rodney Dean DL/ID: 960AA9807 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: 8/31/2012 8/31/2012 IOWA *'''c, ).0.T. r'.^^" Ste= office of Driver Services yDR10, — Iowa Department of Transportation 8/31/2012 Au_k.27. 2012 4:26PM Div of Criminal Investigation No. 1226 P. 1/6 --- 918I 'ON 061:6 ZfOZ •ZZ'enV awi j paelala� C'yir�Ti (--)1 1^11[7 A Criminal 1iisto�ry Record Check 10! Iowa Division a(Criminal lavestigation Support Operations Hureou, I" Floor 21,51;.7m Sfreet . Des Moines. Iown 50319 (515) 725-6066 (915)725-6080 Fax 1 am remia,ram, m rnwa Crimiwo! uzc#n v Rnr.,.d Del Aie.^,aw --, r,bW: nac,_F ` syur _ ('d'applicable) XCHU- Cab of Iowa laity Boz 4213 Iowa%ity, U. 52244 (319} 330477" than ray.; (319)339-7302• Last Name (mandmo Fil'st N219-5 -�71 ' Iui.- 0 ,Ha`1. E (rerom rndctiy ad i+2 I Oeq,A I ;Bate of Berth (T 2w=) Geudiar (mwddadr) Social-aecur3' ' Number (rccommeadea) j ✓ I Wale OFerna]a rr_•._- r rarveY trtjOrmafiOn.- Without a signed waiver horn the subject of the request, a complete criminal history record m`a}' not re. MnbiO, per Code of lowa, Chapter 692.2. For complete criminal history. record information, as allowed by law, alway_ s eb!ai:araivars;-raatorefromihesuhecloftherequest. �wiV2r,MC1CaSea hereby give permission Por the above requcstiog otiteid to conduct m lava criminal h{noly rw,ro check,vhb,he Division ofCrimina! Any crimi,wi binory num conacming are (bar L maialeincd by die DCT maybe ,eleascd�a9paltawtd by laW. iraiver5ignature:_ v PJ I Iowa C t—iminai ciisiory Record Check Results AS of a search of the provided nettle and date of birth reveAled; L _I No Iowa Criminal History Record found with DC1 L� Iowa Criminal 11istary Record 9ttarf eA DCC H DCI initials M� _ DC1-17 (08125110) Am 23. 2012 4:96PM D:,j o, Crim real hvestizat:or. IOWA CRIMINAL HISTORY DCI 00316955 FELONY CONVICTION pmr.. i nR R DATE PRINTED- 28i2PfiHf27 DC;;00316955 NAME-, ELAIR.ROD sLAIR.RODMEY DEAN nOa RS`.X RRC HGT WGT EV2 HAIR Hpq 4OT] 19560305 M W 601 270 HAS SRO MED IA ADDITIONAL IDENTIFIERS SC R WRIST PC Us ARM CCH RECORD *'*° 01 ARRESTED 19040401 AGENCY: IA0520200 IOWA CITY PD 'CHARGE NO- 01 TA'STATOTE 1A715-1-6 PLS USE FIN INSTR 200 TRX#; L25803001 COUAT DISPOSY710N AGENCY', 'IA052015J 'JOHNSON'CO DIST 'COURT COUNT NO- D1 IA STATUTE IA715-1-6 RLS USE PIN INSTR 2ND CHARGE CLASS; STATUS UNiENOWN TRK#, L25803001 SENTENCE JAIL 11D 02 ARRESTED 19840530 AGENCY: IA0524200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-2 THS@T 2ND TRK{: 1,25003101 COURT DFSPOSITION ACENCY't I"AQ52015J ' JOHNSON 'CO DIST COURT COUNT NO- 01 OPERATE MOTOR VEHICLE W(OUT OWNER CONSENT CHARGE CLASS: MISDEMEANOR -CONVICTION TRK#T L25803202 SENTENCE PLEAD GUILTY .TAIL ?2D 03 ARRESTED 13850625 AGENCY: IAD520200 IOWA CITY PD CHARGE ,NO- D1 IA STATUTE TA714-2-5 THEFT STH DEG TRKA7 1,25803201 COURT DISPOSI' ON AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-5 THEFT STH B96 DISP EFF DAT, 19940412 DISP EPF DAT -19840022 19840822 tip. 1226 P, 21F' 1n,.?7. 91-1, 1 4P pi,: of DCI O031F95S FACE 2 OF 5 LARGE' C? -'A S: MI$UEFPu�.:iOR �`p?'.x?•z._=Opp SENTENCE DISP EFF DAT PLMD OUiLTY 1983Q7D`0 ark}E $100 I9Q5Q7QR 04 ARREMP 198507145 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- OS IA STATUTE IA7.13-5 HURG MM DEC Ta?€; ; 1.25500102 COURT DISPOSITION AGENCY; IA052015,I JOHNSON CO DIST COURT COUNT NO- 01 TMAFT 4TH .CHARGE Ct ASS; ,.,-IgDEME-;NQR CONVICTION TRIC#: L25803301 RESTITUTION SENTENCE DIS? RFP W T PROEATIO:: SY -.f.S1002 SUSPENDED 90D 19051002 05 ARRRSTHD 14860120 A@$NM IAQ520200 IOWA CITY PD CHARGE INC- 01 IA S=AKE Ia7i4-2-2 THEFT 2ND DEC TR"ff^ L25-03401 COURT DISPOSITION ACMUM,; 710530"5.7 70:4488014 CO DIST CGUHZT COUNT NO- 01 IA STATUTE IA714-2-2 TREFT 2ND CM E CLAS: FELONY CONVICTION TRK#: L25GG3403 SENTENCE DISP EFF DAT MORATION 5Y 19570'_?9 CREDIT 22D 06 ARRRSTOD 1: Au .77. 7^17 :96°" Jii' �i P• :• nr•T nnil aasc PAGE 3 UN 5 CHARGE CLASS; FE7,ONY CODVICTION TRKN,: L25903501 Anti TYT21TTPiR SENTFNCR nrco EFF DAT PROBATION 5Y 19970+29 07 ARRESTED 19870107 AQ.^.NCYi TAn52n0o0 JOHNSON CO 50 CHARGE NO- 01 IA STATUTE IA700-9 WILLFUL INJURY TRKO: L2S803601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 TERRORIS€4 CHARGE CLASS: FELONY CONVICTION TRM L25BO3601 RESTITUTION SENTENCE DISP EFF DAT CONCURRENT W/CYCLE DOA 06/10/86 19870226 PROBATION 5Y 19070226 OB RECEIVED 19B70129 AGENCY; IAC52015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT 2ND TRT(#: L25803701 INMATE 0: 803150 CHARGE NO- 02 IA STATUTE IA715-2-4 THEFT 4TH TRKVi LZS803702 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE ZA714-2-2 THEFT 2ND CHARGE CLASS: FELONY CONVICTION TRK#; L25003701 SENTENCE DISP EFF DAT PROBATION 5Y 1SS70124 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DISI' COURT COUNT NO- 02 IA STATUTE IA714-2-4 THEFT ITH CHARGE CLASS: MISDEMEANOR CONVICTION T910; L25003702 SENTENCE DISP EFF DAT h 11. 1f719 G:o7na /1111 1/�V V111111 IIII III Vf�� _ DC'I 00316955 nnrR n OF S CONSECUTIVE SENTENCE WITH CT 01 19870129 MAIL onn 19970129 COURT DISPOSITION ar_p.mrv. Tana; 7nl 9.7 Jr,Hucnm rn nTam rnrrmr COUNT NO- 03 TERRORISM CHARGE CLASS: FELONY CONVICTION TRK#; L25001103 CFNTF.NCS$ nTAP PPF TiDT JAIL 5Y 19870226 CONCURRENT WITH CT 01 &r 02 19070226 CUSTODY AGENCYr IA053015C ANAMOSA MENS REFTY RELEASED BY COURT ORDER CUSTODY AGENCYs IA053015C ANAMOSA MENS REFTY B 19070226 pnRIVED RETD ON COURT ORDER CUSTODY AGENCY: IA071015G ADULT PAROLE SVC C 19800302 o LROT-pD CUSTODY AGENCY: IA052015M OAiCDA4E IMCC D 19801203 PAROLE REVOKED CnArOnV Arp..NDV- TA077015C ADULT PAROLE SVC E 19890510 PAROLED CUSTODY AGENCY; XA0770150 ADULT PAROLE SVC F 198903?1 DISCHARGED FROM CRIMINAL JUSTICE SYSTEM 09 ARRESTED 19981116 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 02 IA STATUTE JA906-1 PAROLE VIOLATION TRX#: L25903801 COURT DISFOSITION AGENCY! IADS20ISJ JOHNSON CO PIST COURT COUNT NO- 02 iA STATUTE IA906-1 PAROLE VIOLATION CHARGE CLASS: FELONY CONVICTION TRX#! L250B3801 SENTENCE DISP EFF DAT TO SERVE DAL 06/10/86 19900703 10 ARRESTED 1990llD2 AGFNr - G juii 4:,',1,, vi+ 07 l•iia>;vii in':23i;'8ii26 DCS 09316955 parr` na s IA052020B IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-1-6 TH#HT 1¢T TRK#: L25503901 COURT DISPOOITXON AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 TA RTATUTR Tn914_?.l THEFT IST PRARnfi PiASR• FRi,nNV MMR TrMTnm TRK,#: L25B039D1 SENTENCE nrcTa ppm nam JAIL l0Y 19910912 In rncnyg 11 RECEIVED 19910913 AVP.VnV • TAngi ni FM nnVnaT.v rrsrr CHARGE NO- 01 IA STATUTE IA714-2-1 TRUFT 1ST TRK#: L25004001 INMATE 4: 803150 PniiAT nTA9ARimrnW AGENCY: IADS2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-1 THEPT AST l RA.R(:R f i.apR• RRI',nN'V 1 nmzrrTnV TRK$: L25004001 SENTENCE DISP EPP DAT JAIL l0Y 19910913 CUSTODY AGENCY: IAD77015a ADULT PAPOT.R PUP A 19940714 PAROLED CUSTODY AGENCY: IA077OISG ADULT PAROLE SVC R ROOCII'Ilq DISCHARGED FR014 CRIMINAL JUSTICE SYSTEM AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THtR RFnnvD MAINTAINED BY THE IOWA DIVISION O$ CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY RE RELEASED TO NON -LAN ENFORCEMENT AGENCXES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS EASED ON INFORMATION FURNISHED. WE CANNOT MNPTPM nu nRNY "hA •r V. VrrmVn COVERS THE SUBJECT OF YOUR TNOUIRY. DIVISION OF CRIMINAL INVESTIGATION