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Home My WebLink About12-262� r CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319) 356-SO40 (319) 356-5497 FAX First 1. Name �c Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 2. Mailing Address .SCS\ P 0.� 3. Telephone: Home 4. Prior experience in transportation of passengers: /'�2 -(�)_�a�)_ (Office Use Only) Other:S�1-v�l.�,g 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? T�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?!�:kr) Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 1Sr� Type of offense Where When 8. Has your drivel's license or chauffeurs license been suspended or revoked in the last five years? 1So 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) clerMt idriv g 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ��t 4W X-c)n\\ . 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 Appli 'nt Date 1 STATE OF IOWA ) COUNTY OF JOHNSON ) Su gibed a d�sworn to before me by 1 2 r-r'Yte ( Ca On this 30 "�- day of KELLIE K. TUTTLE commission Number22tais Notary Public in and for the State of Iowa agrlpWlip� 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). Signa re of Police Chi 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 r—tato a 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 1,-7 /02, Date cleb xidnWadgeapp201Odec 09/2012 Iowa Department of Transportation I! Office of Driver Services (Toll Free) BM -532-1121 PO Box 9204, Des Motors IA 5030" 2134 515-244-9124 FAX: 515-23941337 Certified Abstract of Driving Record Inquiry Date: 10/30/2012 DL/ID #: 554XXOS11(IA) Customer #: 604334 Name: Carter, Jermel Donyea Class: D ID Status: None Address: 207 1/2 6TH ST APT 2 Audit #: 6241883 DL Status: VAL Issue Date: 08/23/2012 CDL Status: VAL City/State: CORALVILLE, IA Expiration 11/08/2013 CDL Cert Excepted Intrastate 522412556 Date: Status: Endorsements: 3L CDL Med None Status: Mailing Address: PO BOX 5151 Restrictions: Commercial Instruction Restriction CDL Instruction Permit Permit Supplement: Expires 1/14/2013 Date of Birth: 11/8/1975 Mailing City/State: CORALVILLE, IA Sex: M 522410151 History Information CLEAR DRIVING RECORD Name: Carter, Jermel Donyea DL/ID: 554XX0811 Pursuant to Iowa Code §321.10, 1, 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: J-` %n ;......... Mt"4 10/30/2012 . = frvic......Office es of Driver eof flIYE IowaDepartment pTransportation Name: Carter, Jermel Donyea DL/ID: 554XX0811 Oct: 9. 2012 11:12AM Div of Criminal Investigaliun DCI 00549419 1019A CRIMINAL OF SAGE 1 OF 2 MISDEMEAI7OR CONVICTIONS ONLY DATE PRINTED - 2012110/09 DCI:00549419 HOT •AGT EYE HAIR SCa DOB POD NAME: CARTSR.JERM9L DONYE SEX RAC 150 BRO ELK MBR IN 19751100 M B 506 ADDITIONAL IDENTIFIERS TAT R ARM CCH RECORD 4f• 01 ARRESTED 19970419 AGENCY: 1"0520100 CIA STATUTE PD 'p-124124 -401-5 CHARGE NO- OI MARIJUANA POSSESS SCRSDUL9 I/ MARL TRO 032241601 COURT DISPOSITION JOHNSON CO DIST COURT AGENCY: IA052015J COUNT NO- 01 ; POSSESS 50119DULE I/MARI Rp CONVICTION CHARGE CLASS: MISDEME TRIC0t 032247601 SENTENCE $300 FINE i 02 ARRESTED 19901296 CoRALVILLE PD AGENCY: IA0520100 IA70B-2P.(22) IA STATUTE CHARGE NO- 01 CAD BODILY INJURY DOMESTIC A99AVLT TRK#: 032250501 COURT DISPOSITION 15J JOHNSON CO DIST COURT AGENCY: IA STATUTE IA236-2 COUNT NO- 01 DOHgBTIC ABUSE MISDEMEANOR CONVICTION CHARGE CLASS: l TRO! 032259501 RESTITUTION SENTENCE 60 r. JAIL x'$20 FINE COURT COSTS lY PROBATION 03 ARRESTED 20010415 AGENCY: IA0520000 JO NEON CO SO In I STATUTE CHARGE N0- 01 ASSAULT/INJURY/DOMESTIC TRKO: 100215201 COURT DISPOSITION JOHNSON CO DIST COURT AGENCY: IA052015J Ip723.4 COUNT NO- 01 IA STATUTE �4 • .4 OISP EPP DAT 19970914 DISP EFF DAT 19990423 19990423 19990423 19990423 Ocf. 9. 2012 11:12AM Div of Criminal Investigation 11u.�wu j • I DCX 00549419 PADS 2 OF 2 DISORDERLY CONDUCT COURT CASE ID; 06521 AGCR038558 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#; 100215201 SENTENCE DISP EFF DAT ,1AIL 4D 20010824 CREDIT W/TIME SERVED 20010824 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF QUILT. 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 DCS. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD 15 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. i DIVISION OF CRIMINAL INVESTIO TION I i I 1