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Home My WebLink About12-2497. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When r—D 02-21.1-2v// SnPOi) 11) nzi__,,.,i/ z:�.-i -I-„ „i - t2- 2A. S. Has your driver's license or chauffeur's license been suspended or revoked in the last Yve years? A.10 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) A10 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW ;-C)nli1 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) dwnapmmbaaa 09/2012 r Authorization Number_ la - a1f9 (Office Use Only) ahs iWYt®rte Il OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 'Washington Street between 8 a.m. to 3 p.m., Monday—Friday.) :Iowa 52240-1326 S+_ 6-5040 56-5497 FAX Naa First Middle ast ie —{I 2 r _.ailing Address -1 11 () Ll P orxo If,; C. i-)., r I� ° F4 ad fc t,,A f '��g S 2.1 11 5 c. Telephone: Home 3 1 cl - L -i -�f l — 3 � 7 3 Other: 4. Prior experience in transportation of passengers: P � S Se vt y { 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? lV O Type of offense 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? /o Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When r—D 02-21.1-2v// SnPOi) 11) nzi__,,.,i/ z:�.-i -I-„ „i - t2- 2A. S. Has your driver's license or chauffeur's license been suspended or revoked in the last Yve years? A.10 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) A10 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW ;-C)nli1 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) dwnapmmbaaa 09/2012 J hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license I understand that if I falsely answer any questions in this application.. application knay be denied. I understand that if I falsely answer any of the questions in this application, that this applic,, be denied. I agree that in making this application, I consent to allow agents or employees of the City of Iowa City, li, their discretion, to examine any and all records and documents relating to this application, and I further agree that, if a I 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 it of a Notary Public) Signature of Applicant DatejiL- ? d.2 s # # STATE OF IOWA ) COUNTY OF JOHNSON ) �obscrib d nd sworn to before me by J i Il On this day of D-0 the State of Iowa My 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). /U-i�7-1 a 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. SignlijLufe of City Clerk or designe Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update Ile-/-/- /I-;17� Date dwk4a,dambadgeapp201ad= 0912012 Oct: 10. 2012,10:41A Div of Criminal InvestigationY _._... _,., -- .. iSTAT19 Off' XOWA-. — �rHm s>ral,lHCaSeory Record Cheek Request Form To; XowabirislotcorcrrininalYnvastlggt(on Support Operatlon9 Aw ouu, Ir' 1)raa, 215L. 7i4 WOOD DaslXolnwJo)vq Song (sly -729.6odd 15) 725-6o8o )715Yc LastNaihe 1No.8596 LV7T�P; 4/7 DCXAcoountgumber; 4 o C 2—�z (Ifappll066 c) Wow CITY oS w- CT 1 P CITY CL$Jt 's 0ra1:0 410 E. 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NCI «oeab> As of� %Q — /U — a _ y a seacch of thopXoVicfed name and dafe of birthsevedlod; ' c-> No rbwa Ca'buihoi Matory Record fo=d. with D CT ' 16WACziminfilMatoxyRecordattached, 1)C1# DCS iuifms� ieceived Time'6cf. 1 2012 2:58PM No.4541 Iowa Department of Transportation Office of Driver Services Noll Free) WO -532-1121 PO Box 9204, Des Moines, IA 503W92D4 515-244-91244 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/21/2012 DL/ID #: 769YY9401 (IA) Name: Tlet, David Cuong Class: D Address: 1404 PRAIRIE DU CHIEN RD Audit #: 2117117 Restriction None Issue Date: 05/07/2008 City/State: IOWA CITY, IA 522455614 Expiration Date: 01/04/2014 M14 Fail to Obey Traffic Sign/Signal Endorsements: 3L Mailing Address: 1404 PRAIRIE DU CHIEN RD Restrictions: NONE Date of Birth: 1/4/1970 Mailing City/State: IOWA CITY, IA 522455614 Sex: M History Information Convictions Customer #: 2348748 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Fail to Obey Traffic Sign/Signal Citation Date Conviction Date ACD Explanation County 7UR 02/24/2011 02/25/2011 S92 Speed (10 mph & under in 35-55 mph zone) 52 IA 07/31/2011 08/01/2011 M14 Fail to Obey Traffic Sign/Signal 52 IA 12/28/2011 03/14/2012 M14 Fail to Obey Traffic Sign/Signal 52 IA :^:dents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number IUR 10/31/2008 469206 IA 02/13/2009 494177 IA 06/06/2010 575119 IA 02/03/2011 615890 IA Name: Tiet, David Cuong DL/ID: 769YY9401 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: L 8/21/2012 IOWA' l :sV � 4, ). 0. T..-4 r r'••••''gr Office of Driver Services Iowa Department of Transportation Name: Tlet, David Cuong DL/ID: 769YY9401