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CITY OF IOWA CITY
410 East Washington Street
Iowa City, Iowa 52240-1826
(3 19) 356-5040
(319) 356-5497 FAX
1. Name 'i O
2. Mailing Address Q D
3. Telephone: Home 311 o
4. Prior experience in transportation of passengers:
Authorization Number
APPLICATION FOR TAXI DRIVER
(Police Department review must be made
between 8 a.m. to 3 p.m., Monday — Friday.)
Middle
Other:
5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere?
i�Z -93
(Office Use Only)
Type of offense Where When
iAfox. awe -id ?
6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five
years? Vo
Type of Offense
Where
7. Have you been convicted of any traffic offenses in the last five years? -I(e
Tvoe of offense
S Peed
Where
When
When
(' 'V opo 0 �s c -a dog
S?eel 7-a-dG o 7
8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? / VU
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)
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)
deMrt i&vbadg 09/2012
I hereby ,g§eertify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number
4&n-Lz ? 0 9 / I understand that if I falsely answer any questions in this application, that this
applicat' n 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) 17
Signature of Applicant !{ fes 4� /��� Date NU14
++++aaaaaaaaaaaaa++++a+e++++++aa++++aa+a+++a++aa++a+a++s++a+a+++++++++++++++++++++++aaa++a+++aaa++aaa++aa++aa+++a++++aa+aaa++a++++++++++++aaaaaa
STATE OF IOWA )
COUNTY OF JOHNSON )
and sworn to before
— ;'�
me by -J 0 �p
k— SDJ Q1 A—C, -
On this 2 qday of
I , .•. � .
KELLIE 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).
alble-
Sigrre of
r�Chiel or designee
�-a
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.
Sign'attire of City Clerk or designee
Taxi cab businesses are required to provide Driver Identification cards.
'7-.2- g- 1.2-
Date
aDate
++++++++++++++++++e++++++++aa++aaaaaaaaaaaaa»aaaaaa+++++++a++++++++++++a++++a+a++aa++++a+aaaaa+aa+aa+a+aaaaaaaaa++++++++++++++++++++++a++++++++
Office Use Only
Approved application
DCI report
State certified driving record
Website update
dx ddwadg�pp2010. 09/2012
oei Sep. 26. 2012 11:30AM
Div of Criminal Investigation DCI Ion;No;6275 P. 1/1
STATE OF IOWA
Criminal History Record Check
)R.tquest Form
To: Iom DMdoe of Criminal113YU1ll!*Iloa
6upport Opaatrooa Bureau, ]"poor
215 E.7° street
Doe MOWS, lawn 50319
(515)725.6060
(815)126609* Fal
1 nm wnnnatino vn rnWA r!Aminat w.., R."' rl (`herir nn
Dta Amount Number:. y3 —FG
(IfagpkwNe) --
Fralnl AyLr5�0.k1
IIL 54rle wb Or.
phage, ,( 314\ 33P-
3
LaiNamea.ada
Pint Name LTMoaam
MeldleName #9--
515h/W6,X65
tp�, -
Vl l -k- D;Xa r\
Da ofMdh euom
GenderSoda
&nurl Numb
�Ie ❑Female
iia 1 7 W3
Wa11'er!nfarnWbban: Wttboelael�od vraWar rram theaabletorthe requert, a completo ortmlaalhtetaryrecord may not
he rekeemblaper Code *flow*. Chapter 697.1 Fates almi*d Wary record Iadormstlon, as allowed by law, always
obtain a widverilinsfure Onip the rub ed of the requeffl.
Waiver Rebeff6B:I bwwalte eemdab* rot ae ebovatmumtiva ulnad n Om&d in irua ethelsl hhtoq ropehi cheh with oe Div'e'woorC&M
rnrenrpdoo (Drat MycdoccW hWay den ramot�mo Wn a nrhiaitaal q tlnoCl awY la roleuad u NluwodbiTaw.
Waiver Signature: L Jjj, iA C,72�JL V
As of � I 1 Lill \I V , a search of the provided name and date of birth revealed:
Ver No lawn Criminal History )retard found with DCI
❑ Iowa Criminal History Record attaehcd, DCl
DCI Initials
Received Time Sep. 19. 2012 12:32PM No. 5073
roc1uuie ody)n
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Iowa Department of Transportation
Office of driver Services (7011 Free) OM -532-7121
PO Bax 9204, Des Moines, 1A 50306-9204 515-244-9124
FAX: 515-232-1837
Inquiry Date: 9/18/2012
Name: Sodoma, Joseph Walter
Dixon
Address: 3672 GLASTONBURY ST
City/State: IOWA CITY, IA 522452715
Mailing Address: 3672 GLASTONBURY ST
Mailing City/State: IOWA CITY, IA 522452715
Convictions
Certified Abstract of Driving Record
DL/ID #: 837ZZ7691 (IA)
Class: D
Audit #: 6309632
Issue Date: 09/18/2012
Expiration Date: 09/09/2013
Endorsements: 3
Restrictions: NONE
Date of Birth: 9/9/1985
Sex: M
History Information
Customer #: 5103530
ID Status: None
DL Status:
VAL
CDL Status:
None
CDL Cert Status:
None
CDL Med Status:
None
Restriction
None
Supplement:
.02/2009
06/07/02/2009
Citation Date
Conviction Date
ACD
Explanation
County JUR
05/06/20'08'-_
-06/02/2008 _..._
- X592 —
Speed.,_,
Iowa Department of Transportation
05/07/2009
.02/2009
06/07/02/2009
592
Speed
28 'IA
06/03/2009
515
Speed i iIL
?IA
03/29/2010
104/01/2010
:Improper Registration
33
Name: Sodoma, Joseph Walter Dixon DL/ID: 837ZZ7691
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:
..""'••:�%'0
9/18/2012
IOWA2'a'
gas
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Office of Driver Services
Iowa Department of Transportation
Name: Sodoma, Joseph Walter Dixon DL/ID: 837ZZ7691
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This lempo:ary dopumenl beco¢s IA
invalid 30 days atter Issuance —
4
�1 t;k101i"', I t@}� I rIIII I �SODOMA _..
4JOSEPH WALTERDIXON
3672 GLASTONB ST
.I
IOWA CITY,.IA 52245
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pvien95, It You do e.reraive OLNo 63iZZ7691 I
v00R5Et�ENlS: a?.an tommeRi 1p vet"fie r vOUI p^C aneol' .
cmensenoit27 days Iss 0911812012. FJ(R 101 l�120`12,j �M�
please a:l
Esl'Rlc11oN4. 1 800 5 2-1121 Class D End.3 Rest G Co0".;t"
Re tnc5o:a Eyes ORD
tar assyslence. NONE oo .oP:Y
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