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Home My WebLink About12-274' r r � 1 ,4 MOWN %- CITY OF IOWA CITY 410 East Washington Street Iowa wa 52240-1826 -5040 cda OL r11� (319) 356-5497 FAX 1. Name 2. Mailing Address Authorization Number /p2 R (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 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? Type of Offense Where When Have you been convicted of any traffic offenses in the last five years? `(LS Alt_ Tt� 0" MA-u\G Type of offense 0 _ SC Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Tvpe 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) �JZ4, 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) clerk idrivbadg 09/2012 I hereby certi t at I have 'ssued to me by the Iowa Department of Transportation a valid Chauffeur's license number W, l (��°�� . I understand that if I falselv answer anv auestions in this apDlication. 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 Date v� - STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by nn er� (4cl On this ad day of •I SONDRAE FORT Commission Number 159791 My commission Expires Notary Public in and for the State of Iowa 1 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). Signature of PoliceVief or designee 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. igna or 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 Date derMt idnWadge,2010 dx 09/2012 Lr !!Transportation Office , , Department(Tolle r r PO Box 9204, Des Moines, IA 5030&9204 515-244-9424 to Inquiry Date: 11/14/2012 Name: Cady, Robert Gene III Address: 31 PONDVIEW CT City/State: IOWA CITY, IA 522403028 Mailing Address: 31 PONDVIEW Cf Mailing City/State: IOWA CITY, IA 522403028 Convictions Certified Abstract of Driving Record DL/ID #: 811PP6357 (IA) Class: D Audit #: 6255286 Issue Date: 08/29/2012 Expiration Date: 07/29/2017 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 7/29/1952 Sex: M History Information Customer #: 222201 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Fall to Obey Traffic Sign/Signal Date Conviction Date ACD Explanation _.. _ .....�. ___ County OUR _ _Citation ... ..�.._..� .._.�... -:01/29/2008 F mm M14 .. Fail to Obey._.... Traffic Sign/Signal _ 52 2 IA _01/08/2008 12/31/2008 � __ _ w01/26/2009 M14 Fall to Obey Traffic Sign/Signal 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 7UR 12/31/2008 :485621 IA Name:Name: Cady, Robert Gene III DL/ID: BlIPP6357 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: "'••:;G/ �p 11/14/2012 IOWA %o D. 0. T. 7f ....... Ste= Office of Driver Services Iowa Department of Transportation Name: Cady, Robert Gene III DL/ID: 811PP6357 Nov.21. 2012 4:02PNy Div of Criminal Investigation H „ I., L1I1 L.J/,,, '/,,, v,,., •1 v1„ VI ,V11Y VI,y 1No.5128 IP, 1.1/1 ., aflcijo L Cr9minal.0storyRecord Check RequestForm I)CIA.cconntNumbor. ' � � UfopDltcnb e) To; ioWabSGtsfgttofCl•Im1'na1Ywvewggtloh 5rom: rrry ox' J:Om a= SnppoYfOpafat(gns)IDurcalt,l'Ipioor Cx7:X CL-gRxrS Ckpxa 2150,7n`Urcot 41n R. VASBING'1017 6 T+7�,$'t D SMpfr1w,rowa SQ�19 (8IS) 9276x66 xo�rA ca cg rn�rn a?n�,o (816) 97.E 6oAo Marc Pbono; q19—ash—snk.1 Lraw 319-956-5447 _I_am raquostina, aalowx CrlhriwalHisrorV Record Cheol< on: �, c�d� 11d".MTaTe ' CX�'emaYe , •�� i� rf'atvey'Xrrforma ar�rV4ititontastgnedWrA+Yet'IYomthesubjeetotthoroyuasP,allomplgtacrfinfnplhloforyrecerdmaynot bor'olapsn6Tejper Cob lot-crinitnplld4okyreoordtnrohnnlfon,rig allewCdbylav,pfwpys obtafn ft wafverstan4furahoro t$e•sublocE o fffio a egilost," �lLI�EN�BrB!(.f'8; Thcrcbygfve perrolrs(on tbCthoa6ayeregacslingolnciAl fo rohCuo! art YoN'a or{minnl hhfotyfuofdchock y6Q, IRe D,�islon orCrimina! nv�sltgadoA(0'Cp.,AnyorlmkelAfatorydnlacG�umlrcgrrto�ha matnlafneC6y�16on0 oy� rofouogDsnlfoly<46y1nW, Waiver.Stgnretfats;,_,_s„� �� - - . Aawa Q.:1Cmijklal ImstolyReEard chock l ' •.�:.:'�• .moi :�:? Aso 1, h ;La senzoli b fthe provided name afi4 410 d•birth-revealed: No Iowa CiminaIiistozyltecord found with DCZ (7' YocYaCtlmtnalliisfozyReeo�datiaohed,bCi t PO bC itritiaLv— Received Time `Nov. 14, 2012 2:35PM No, 6152