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Home My WebLink About12-240First Middle Last � 1. Name AVS (f 14 At (A 2. Mailing Address �YaZ S ()U St 1 ia�Ma aye 3. Telephone: Home 31 y % I ' -7U ) S Other: 4. Prior experience in transportation of passengers: /4 a I) P 0'/ r ' UZ4/ .ti it, C yr 5- 5. 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where j a -)� 4 C) Authorization Number l i (Office Use Only) 1/ 16 - lap �► :III CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington street between 8 a.m. to 3 p.m., Monday — Friday.) Iowa City, Iowa 52240-1826 _ -tna Io12Ti/�S (319) 356-5497 FAX First Middle Last � 1. Name AVS (f 14 At (A 2. Mailing Address �YaZ S ()U St 1 ia�Ma aye 3. Telephone: Home 31 y % I ' -7U ) S Other: 4. Prior experience in transportation of passengers: /4 a I) P 0'/ r ' UZ4/ .ti it, C yr 5- 5. 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When JZ'Af,u QFI VI,, a VLo _WA5s CD 0-19- 1/ 16 - lap 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When (IljCc 90.. Co Way(, [o a -1l // YD /a9Z 7. Have you been convicted of any traffic offenses in the last five years? Type of offense ��// ! /1 Where When 7Oi%f 11 %rI,FF,c CopjfoI &,IjeC ��rildh C'�i/ r-ai-d5 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? LZ n 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) clerWYaxitlrivbatlg 09/2012 I herebyy cgrtif that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number raj W 603 . 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 ( pia Date /e '/--14 H###+H++!##!!++}!}#*#Hkk}#*tf#fff.feffffHffHfH#f1fHHHff#H#H#H#H1#f f1f 1111!!!!1! f fffffHlf f f f f f ifffffff lHfl####f#H## #f,}*3}}f#fk*#H STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by i \ On this y day of p c;F,twn- ao i� �otary Pu)lic in and for the State of lo`wa - Lam_ 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). (7,1244 Signature f olicP p of or esignee /G_ el 1a 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. Signature of City Clerk or design— Date Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update dm imiwad�2010 d 0912012 Iowa Department of Transportation Office of Driver Services (Toll Free) GM -532-1121 PO Box 9204, Des Moines; IA 50300-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 10/2/2012 DL/ID #: 127AC6033 (IA) Name: Toomer, David Alan Class: D Address; 2742 SOOTH ST SW Audit #: 4671306 Issue Date: 09/14/2010 City/State: KALONA, IA 522479214 Expiration 09/21/2015 Date: Endorsements: 3 Mailing Address: 2742 500TH ST SW Restrictions: NONE Date of Birth: 9/21/1956 Mailing City/State: KALONA, IA 522479214 sex: M History Information Convictions Customer #: 1934738 ID Status: EXP DL Status: VAL CDL Status: None CDL Cert None Status: CDL Med None Status: Restriction None Supplement: Date _ Conviction Date ACD Explanation County ]UR ...... __. ........ ...... .. l......._.. .. .. ... .... ....... ... .. ...._.... 09 X02/11/2009 ,M14 rFall to Obey Traffic Sign/Signal 52 IA Accidents - Accident involvement Indicated does NOT mean the individual was at fault or given a citation. Name: Toomer, David Alan DL/ID: 127AC6033 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'�y 10/2/2012 IOWA0. & 416 aeere-='I�'',,x-+ r DBIYtR Sr Office of Driver Services Iowa Department of Transportation Oct. 3. 2012. 11:23AN} Div of Criminal Investigation ct. 3, 0 i. II•23A VI17 orcin VI LY U1 IUWd 1,1 t I c Check RequentForm No, /460 N. 2/5 No. zaYo N. z ACTA,000uatYutnbor; 460 L - — ' pe�PyrYLAer�)� TO; X04YaDivisYOJIOtGnSninaIhfttlKatfon Nr9ms CITY a Tote rrry Supportlop eralTonsaurenv,l'(Floor CITY CLTnl'g OFFICE 215E',71,areaL` 470 II GYAS [tQYTOhT STlZ7ig bov1V(glnos,To)yp 50919 (815725-6c66 TowA ciTv TDAA S J4o (515) X25-baAo �'AYe ' • i'ho961 ?79�a5Fi-•K04t _ x &M Ce uestfn an7owa Criminal ITi or 12aco1d Cheolt oa: - ' T astNama me eaw F1rsl Name (mend6(afy) Midtllo Mme (tecommended) a�rJl )Onto oi'Birth m9ndemry GtOhdoY mandato) SocffllSeoun'i Number rcmminonded �'o�-I '"•�6 �1VlaTe dJEemaTe l- a—� ,. 9� Wn6Ver-inforingdon, Wiihoutn,srgne$ waiver SYolnlfiosubjectotfhorepasi,aeolnplolor iratnal(1lstoryrecordwAy110 Tao fdreaspbie, per Code oYYotvd, Chapter 6971,2, )Yob crlatfna16i8eery record 1nloxmntforg ar gltowed by lav(, 0.1WAys oLtar'n q Watvexsl ha(ore.tYom tfiosab act oi'iTioro r; �lLl'Yei'.�Br8lr5R; l hataDy@Ivo permlrsl0a @t 1hoa6overegoesling oltToidl (o ronduor en tmva c7lminai hrslory[eaoldcfiecl Wilh UiapAisloe ofCriminoY YnYasl1AmToA(De7). Any oYIMULalhts(otydatq bpnpeming7norha[3amalnlefn�ad6�ylkoDOtmpybarcrestod a9 aumva46yta1v. WYlfYAYr�I'�J1r!!GlY'G;_JJ pj/y� �-/�l'1M('M -As Of 2 0' 3' I - a seuch of the provided name and date of bY1th-reveslod; El No ibwa alwinal History knord found wlffi b CZ ,route Giiminal�la�oryRecoxd attached, beZ# � 0 � ! Sa bCXixifials—�� . received Time Sep,25. 2012 11:25AM 1,o.4005 .roCf.Urc only) Oct. 3. 2012 11:23AM Div of Criminal Investigation No.1460 P. 3/5 DCI:00209152 NAME: TOOMER,DAVID ALAN DOE SEX RAC 19560921 M W ADDITIONAL IDENTIFIERS SC CHIN SC R KNEE IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY HGT WGT 511 200 CCH RECORD *** DC1 00209152 PAGE ' 1 OF 3 DATE PRINTED - 2012/10/03 EYE HAIR SKN POB BRO BRO MED IA O1 ARRESTED 19700203 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRIO: L10173201 COURT DISPOSITION AGENCY: IA05201SU JOHNSON CO DIST COURT COUNT NO- 01 OPERATE MOTOR VEHICLE UNDER INFLUENCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173201 SENTENCE JAIL 10D 02 ARRESTED 19060716 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L10173401 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173401 SENTENCE JAIL 2D 03 ARRESTED 19901103 AGENCY: IA0520200 IOWA CITY -PD CHARGE NO- 01 IA STATUTE IA321J-2 0WI TRK#: L10173501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173501 DISP EFF DAT 19791120 DISP EFF DAT 19860717 Oct. 3. 2012 11:23AM Div of Criminal Investigation No.7460 P. 4/5 DCI 00209152 PAGE 2 OF 3 SENTENCE DISP EFF DAT JAIL 2D 19910214 FINE $500 19910214 CREDIT W/TIME SERVED 14H 19910214 04 ARRESTED 19901103 A AGENCY: IA0520000 JOHNSON CO So CHARGE NO- 01 IA STATUTE IA321-263 LEAVE SCENE OF ACCIDENT TRK#: L10173601 COURT DISPOSITION AGENCY: TA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-261 LEAVE THE SCENE OF PERSONAL INJURY ACCIDENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173601 SENTENCE DISP EVV bAT JAIL 10D 19920214 CREDIT W/TIME SERVED 1411 19920214 05 ARRESTED 19921001 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI/2ND OFFENSE TRK#: L10172701 COURT DISPOSITION AGENCY: IAO92015J WASHINGTON CO DIST COURT COUNT NO- 01 OWI/2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173701 SENTENCE DISP EFF DAT JAIL 30D 19930129 FINE 5750 19930129 06 ARRESTED 19931126 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED TRK#: 006568001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006500001 Oct. 3. 2012 11:23AM Div of Criminal Investigation No -7460 P. 5/5 SENTENCE GAIL 2D FINE $250 DCI 00209152 PAGE 3 OF 3 DISP EFF DAT 10940304 19940304 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 1. 0,