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Home My WebLink About12-255CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX First 1. Name TI tA o 1'k Authorization Number /a -ass (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) I I I I cvvl Last r, �! ✓v1 P, I's 'r� 2. Mailing Address ZN b , B vi y b Q It 2 g S To. J a C i±;/ . I—A i S 72L1 O 3. Telephone: Home ( 3 19 ) `f7 I - 4 � 3 `t Other: 4. Prior experience in transportation of passengers: tax, dr, veA- Iw 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? _e - Type of offense Where sc. AOcc'h<<1 reCwd 6�CK When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years N 0 Tvpe of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? 2 S Type of offense Spetol nq 11c- X L When Where When .L4�vok C I V/09 /Oq I FU l"wp' S "iryf12 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? N Type of offense Where When 9. Have you ever applied to bean Iowa City taxi driver using a different name? If yes, please provide the name(s) t\` 0 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) cl d addrivbadg 09/2012 I herebyy certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 7) 5 X X 1 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 cnsent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and do'u relating to this application, and I further agree that, if a license is granted, to comply at all times with all of the �ovisi s of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) t Signature of STATE OF IOWA ) COUNTY OF JOHNSON 1 vt Date I a I 'Ii ` ) 2 hscri ted and sworn to before me by _ i VhOytMA �t( Y( rmeff� . On this a day of ,W I KFLLIEK.TUTrL� GCrC L6f- K— 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 gnature of Police Chief or designee /0 -- '? % / z 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. Signaftum 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 deMnaxWvbadgea,2010.tl 09/2012 ;/' Iowa Department of Transportation j Office of Driver Services (i611 Free) 80 -532-1121 PO Box 9204, Des Moines, JA 50305-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 10/23/2012 DL/ID #: 713XX1449 (IA) Name: Fuhrmeister, Timothy Class: D Restriction William Supplement: IA Address: 2801 HIGHWAY 6 E LOT 245 Audit #: 2474111 Speed (10 mph & under In 35-55 mph zone) 52 Issue Date: 08/22/2008 City/State: IOWA CITY, IA 522402652 Expiration Date: 08/18/2013 IA 08/03/2012 Endorsements: 3 Mailing Address: 2801 HIGHWAY 6 E LOT 245 Restrictions: Corrective Lenses Date of Birth: 8/18/1968 Mailing City/State: IOWA CITY, IA 522402652 Sex: M History Information Convictions Customer #: 1833101 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: IA Citation Date Conviction Date ACD Explanation County TUR 07/12/2009 08/11/2009 S92 Speed 52 IA _ 06/19/2011 07/20/2011 592 Speed (10 mph & under In 35-55 mph zone) 52 'IA 04/19/2012 .05/08/2012 Miscellaneous 49 IA 08/03/2012 09/05/2012 M14 Fall to Obey Traffic Sign/Signal X52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date _ Case Number TUR 12/04/2008 _ .485661 IA 12/03/2009 543217 IA Name: Fuhrmelster, Timothy William DL/ID: 713XX1449 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 10/23/2012 10WA'vy°, .Ci D. 0. T. % 7..."". Ste- Office of Driver Services 4a�1�—'- Iowa Department of Transportation Name: Fuhrmeister, Timothy William DL/ID: 713XX1449 Oct. 24. 2012 11:08AM Lit. iv. t v I L I I - J U nIn Div of Criminal Investigation �11y VICI% V I ly UI lU{(0. 1.I I I '4 `�i I _— b�'> minax-48tory Record (check Request Y �.0.�iy l4 VUL lJ.'Qr�t. _ � r ' .bba Tw Diva bivlslonofCriminalIu aftatioh support op arolrons Burenu, l" p'looe 215 E. YSiroot Des Moirtas)Iowa 50119 (91� 925 -so 66 (818) 925-040 )rare on; 9M No. 1163 P. 2/5 NO. LYJ i P, [ ACI A000unEDillmher: �Oa`'� QfappltraE e) .�i'olni G7� oY( royaA CT2Y' _ " CISX CL7:RK°5 OFPxC]z 470 R T4ra9H"ITLCfO'4 9TRrgy T_CWA CJTY IMYA 52240 Pilonei 919—grw� J147 $axl q19--�5(.--5497 -�- NAwo 69 Dl eio ofRfrth (men lemrvl rP.h f7P,�/ .wl.r.w.t Cin �n7 6�e wJHi T7 w7 e� i , [�.remare -"5-7� - )N7 X- i� n6Verli{/orl�lrtYYnry; Wilhoutastgned�trniYal'lra$ithostlbfootofthoregn8a4 n rompin(o vYilvCnplhistory recordmnp,lot bolo]oasnbleoper CodeofftA,Chapter60.7,7, 7oreomoiotaorlmfualhistory recozdhrformoilou asallowod� ipv�n(Mn s Wlit�e7r,tzelsassr r n� Ynvasllealten (Dcu- NiYodi WalV¢r to As of L0' ` a asearchdThoprovidedname anddaioofbiathxawoaTcd,, NolbwgcrimfnIII l7istoryzecordf'olmdwith DM r/ 7ovPa CriminalNistovRowd attached, DCT# 3 d Q Def i Q(9fl s_At Zeceived TimeV'Oc4. 18, 2012 11: 580 No. 5504 Dyslon orcriminal 1 roci oso only) Oct.24. 2012 11:08AM Div of Criminal Investigation IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00373688 NAME: FUHRMEISTER,TIM FUHRMEISTER,TIMOTHY WILLIAM PURHMEIST5R,TIM FURHMEISTER,TIMOTHY WILLIAM DOB SEX RRC HGT WGT 19680818 M W 600 200 DCI 00373688 PAGE 1 OF 2 DATE PRINTED - 2012/10/24 EYE HAIR SKIN POB BLU BRO FAR IA ADDITIONAL IDENTIFIERS TAT L ARM TAT L CALF TAT L LEG CCH RECORD www 01 ARRESTED 19880403 AGENCY: XA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L33958601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE XA123.46 CONSUMPTION / INTOXICATION - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L33958601 SENTENCE DISP EPP DAT PLEAD GUILTY 19080418 FINE $25 19080410 COURT COSTS $20 19880418 02 ARRESTED 19900401 AGENCY; IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA204-401-3 POSSESSION.SCHEDULE I/MARIJUANA TRK#: L33958701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204-401-3 POSSESS SCHEDULE I/MARIJUANA CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L33958701 SENTENCE DISP EPP DAT JAIL 11) 19900703 CREDIT W/TIME SERVED 8H 19900703 03 ARRESTED 19975005 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 TA STATUTE IA708-2A-2B ASSAULT/CAUSE INJURY/bOMESTXC TRK#: 037285101 No. 1163 P. 3/5 Qct.24. 2012 11:08AM Div of Criminal Investigation PCI 00373668 PAGE 2 OF 2 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA236-2-2 DOMESTIC ASSAULT CAUSING INJURY COURT CASE ID: 06521 SPCR045754 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 037285101 SENTENCE DISP EPF DAT SUSPENDED JAIL 281) 19980115 JAIL 30D 19980115 FINE $250 19980115 PROBATION SY 19980115 04 ARRESTED 19981104 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2A(213)(313) ASSAULT WITH INJURY/DOMESTIC/ENHANCED TRK#: 044597001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IR709-2 ASSAULT CHAROR CLASS: MISDEMEANOR CONVICTION TRK#: 044597001 SENTENCE JAIL SD DISP EFP DAT 19990223 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, 1163 P. 4/5