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Home My WebLink About12-233+. MIIr®rai� CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX First 1. Name 0 4, P 2. Mailing Address Authorization Number ) (3 J (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) Last , 3. Telephone: Home7�� y�b ` y7D� Other: 4. Prior experience in transportation of passengers: C' C4ti 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?_Al 0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? �y/I Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ///% 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) de"idnwadg 09/2012 hereby certi that I ve issued to me by the Iowa Department of Transportation a valid Chauffeur's license number a. � Cl C A . 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 C — Date G /,�-2/— '/A NH+4+H4f f#Hf#Rf MHH##4*#Hf#f!#HR1f#1RM1Hf111fHHNf4fNH#N#4++##N+4411#HHRR#-*feR}!f RRR*ffHfR1HR11flHf f!f f ti###4N##1ttlR4*#*#f f STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by d", -L iFW(S On this .77 day of My commission Expires-] Notary Public in and for the State of Iowa 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). i' -1a2 Signa re of Pol' �9 uef or designee Date Y 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. Signat f 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 /,-g-- Date de =drwbadge�Ml0 m 0912012 --- --9---- -- - - - - -- -- - ------.- - Office of Driver Services (roll Free) 800332-1121PO Box 9204, Des Moines, fA 5030&9204 515-244-9124 ELI FAX:515-239-1837 I Inquiry Date: 9/19/2012 Name: Lewis, James Earl Jr Address: 121 OAKRIDGE AVE APT 8 C:C{/State: HILLS, IA 52235 Mailing Address: PO BOX 255 Mailing City/State: HILLS, IA 522350255 Name: Lewis, James Earl Jr OL/ID: 247CC9583 Certified Abstract of Driving Record DL/ID #: 247CC9583 (IA) Class: D Audit #: 4823048 Issue Date: 11/16/2010 Expiration Date: 10/24/2012 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 10/24/1977 Sex: M History Information CLEAR DRIVING RECORD Customer #: 2915109 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: 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: Name: Lewis, James Earl Jr DL/ID: 247CC9583 a.••""••%�f/i'4� 9/19/2012 10 WA e •r Pf Office of Driver Services iA1YEI 'ay,�� Iowa Department of Transportation C 9/19/2012 Sep.27. 2012 9:22AM 09/hur coat u. vd rm Div of Criminal Investigation , pCI'lowNo.6440 P. 1/2 STATE OF IOWA Criminal History Record Check ....—Request Form__. To; Iowa Division of Criminal Investigation Support operations Bureau, I" Fiber' 215 E, 74 Street Des Moines, Iowa 50319 (515)'1254066 (515)715-6080 Fax �r�„t IIr,p1 7 s-- 'rie,1�etd�al DCI Account Number: 43 83-K (irappumbio) From: Marco's Taxi 116 Stevens Dr. Iowa City, la 51240 (319) -331 -8194 - Phone; Fax 37-8194Phone- Fax: (319)351-8194 l am wguo3ung w+ avww v+o......... Last Name (mendamy) ............••--•• -••• FirsttN"alne wmdalory) - Middle Name (n=wmendod) wetoao on] p the name and date of birth revealed: �. As of/I / v Social Security Number (recommcndcd) Date of Birth (mandwlury) Gender mandato a is Waiver, Information; Without a signed waiver from the subject bribe request, a complete criminal history record may not be releasable, per Code of Iowa, Chapter 691.2. For Semntete criminal history record information, as allowed by law, always obtain a waiver sl nature from the aub act of the re nest. Waiver Release. i hereby give rgnnlz,lon Nr the ebovo requaning oaicid to condurt on Imre criminal htdveyrecofd eheok whh Ihd Division oredininal tavicerlgmion (DCI). Any criminalhistoydae cpnremI g me that Is malatalacd by IheDCI may berelcased as alrmved bylaw. Waiver Signature: r ❑ Iowa Ur mi al nisiory Zeecorg A%rmg tis mom• wetoao on] p the name and date of birth revealed: As of/I , a search of provided �a r ❑ No Iowa Criminal History Record found with DCj :1• I -o DCI 4 Iowa Criminal History Record attached, DCI -77 (08125/10) Received Time Sep -20. 2012 11:060 No, 3668 9:22AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00950664 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - DCI :00950064 2012/09/27 NAME: LEWIS,JAMES EARL JR DOB SEX RAC HOT .WGT EYE HAIR SKN POE 19771024 M E 601 300 BRO SAL ALK IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT LF ARM CCH RECORD •�* 01 ARRESTED 20120228 AGENCY: IA0620100 OSKALOOSA PD CHARGE NO- 01 IA STATUTE IA708.7(1)(a)(1) HARASSMENT BY COMMUNICATION TRK((: KE002S901 COURT DISPOSITION AGENCY: IA062015J ,MAHASKA CO DIST COURT COUNT NO- 01 IA STATUTE IA708.7(4) HARASSMENT / 3RD DEG. - 1989 COURT CASE YD: 08621 SMSM167780 CHARGE CLASS: MISDEMEANOR CONVICTION TR0 : KE0029901 SENTENCE DISP EPF DAT FINE $65 20120228 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 FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY, DIVISION OF CRIMINAL INVESTIGATION No -6440 P. 2/2 So