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Home My WebLink About12-230CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name 2. Mailing Address 3. Telephone: Home ')[ y 4. Prior experience in transportation of Authorization Number ��-02 e? (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday – Friday.) Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 6. Have you ern convicted of operating a motor vehicle whi a under years? /V/7.'-. 12 C D e-44- A" On Have you bMn ponvicteZI of agyttrgf#boffe9ses#rtha4ast five years? 8. Has your dri\Ws license Type of offense of been suspended or revoked in the last five Where When in the last 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) dere driWadq 09/2012 I hereby certi that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number G']5 W. . 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 1RRR##R*RfR111R*111f*##**f#*'*f###H*#}i##fe*****;RNR;;f**i*f4#tff**f1HM**fffYfffiff;llNflf#f;Mfffffff11f11Hf1ffR*fRf1ff11f1ff111f1f*f#f#fRY STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by 6 r.4 r'r,5 f% On this a,G day of r o s SOND' A FORT r Commission Number 159791 M commission Emires Notary Public in and for the State of Iowa R##*k*****%#*%kt%4N34#N#tii#t{fH3fRRR#*RNNffR##fRRR#RkR#*f#Rkk#*k**#*k**R}k*R***Rk*****#*%*#k#R4t##kt***4*#tt#4Nt#*3*44t34434k413fttf3#4#f 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). Signa re of P f or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. 1�?iG«ifr/ e- e'-Z'� Signbiture of City Clerk or designee Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update Date derW drNtadg a,2010.tl 09/2012 ASep.25. 2012 10:15AN Div of Criminal Investigation Y Cx;fminaUf3 story Record Cheek Request Form To: YowablvlaloliorGAninalXnvatl'won Support Operations Bureulr, 0 pro Or 213E, 714Stree> begMglr(e9)Xowa S0319 (513) 729466 (61-5) 12$4080 krox Mot->�w Dpfo OPBiYl Gmendaro P✓asver l�fol7nntYon: Wlthouf a ho a'elea9able, per Code oPYAWA, Ch • nhtloln a wnhre...1,.....8. e., rt "Y Wn1Y'1' �eiBdSe ThcrotyptvePerm Wron Ynrasggaitan(flcU. rtnyorimfnalldalArydaMop T�iilaers'ienrrYur's: � As r Rod Ch bYrstName BTS (�ehQoz +m C walverfrom lh( 692.2, )?orwlpl C ggo 1'egU09t oabovaregaesilogda ngmeilra[lsmalAmin INo,. 6013 1. U IT Ir1P. i /15 AClticoounEll'umber: �C]a—}� OlapylraADYc) Yhom; CtTX OF TOGTA�C� CxTJC CLBRAC' S pFFTC� -_.. - kin ir, wasilrl,�xoN 5TCZrsBT 10'W'A CITY T057A X 240 Phone;—�Yg-9S6,50G7 ,4 ElFomalo Sol of tho regaaAL•, a camprcto otltginat history Yeaord mapnat n al htatory recol'dlnfotmn t(ohr as allowed by 1GW%, p(Cvays conductMYONVActlmrridtsloryteeoMcheck withl aDlWalonofCrlmtnar ioboYmby bo tolo0.sod as rllowed Dyinw, a search oftheprovided name and date of With revealed; No Tbwa CrlmfnalI istoxyAecord found wldlDa %araCsiminal 7isfozgRecordattached,I)cx# )Da fwflals—Y4 Seceived TimO,Sep. 14. 2012 3:14PM No, 3289 (110110 only) r.•r r\j 0 Sep,25. 2012 10:15AM Div of Criminal Investigation No.6013 P. 3/15 IOWA CRIMINAL HISTORY DCT 00299366 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- 2012/09/25 DCI;00299366 NAME: MORROW,BRET ALLEN DOB SEX RAC RGT WGT EYE HAIR SKN POS 19640403 M W 602 345 GRN RED MED IA ADDITIONAL IDENTIFIERS SC CHEST CCH RECORD **• O1 ARRESTED 19030115 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE YA706-1 ASSAULT TRK#: L23192401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708-1 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L22192401 SENTENCE DISP EFF DAT JAIL 301) 19830413 COURT COSTS $9 19830413 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 DCT. 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 t Iowa Department of Transportation Office of Driver Services (Toll Free) MU -532-1121 PO Box 9204, Des Moines, IA 503W9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/14/2012 DL/ID #: 075AA1630 (IA) Name: Morrow, Bret Allen Class: A Address: 916 20TH AVENUE PL APT 2 Audit #: 5065101 Restriction None Issue Date: 03/08/2011 City/State: CORALVILLE, IA 522411423 Expiration Date: 04/03/2015 Endorsements: NPT Mailing Address: 916 20TH AVENUE PL APT 2 Restrictions: Corrective Lenses, Except Class A Bus Date of Birth: 4/3/1964 Mailing City/State: CORALVILLE, IA 522411423 Sex: M History Information Convictions Customer #: 3617557 ID Status: None DL Status: VAL CDL Status: VAL CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Citation Date Conviction Date ACD Explanation County IUR 02/08/2011 03/08/2011 N01 Fall to Yield Right of Way 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number IUR 04/26/2007 368947 IA 02/08/2011 617539 IA Name: Morrow, Bret Allen DL/ID: 07SAA1630 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: """••.tg 6/14/2012 IOWA �-O =4-v �; $�- Office of Driver Services .�valviv, ` Iowa Department of Transportation Name: Morrow, Bret Allen DL/ID: 075AA1630 IOWA 916 20TH AVENUE CORALVILLE [A DE Na. 075AA1630 Iss 03/0812011 EXP ci.sR smoE.d NPT BM DOB 0 410 311 9 1