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HomeMy WebLinkAbout12-282CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name 2. Mailing Authorization Number 0- -) V -- (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 /' X51- LU / &I 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? Tvpe of offense Where . , Wt 6. Have yoxy een convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where When 9. Have yott dWr 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 19 _7'O I 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) clenOwidrivbadg 09/2012 I hereby certify have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 1 L y . I understand that if I falsely answer any questions in this application, that this application ma e d eniedd.. rI 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 of a sions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front with all of a Notary Public) I N /� rov Signature of Appli nt ll�j Date Z `^ 2c,)/ ******rtM*4*#**###*#+*#+*#+*####*#*R**RRR**************Y*RR*MRMRRYRRRMYMYfRMYYYRRMI#RRRRYY##RRRM*Y*MY**Y4R*#*YY#*#***Rf#*4####**###*#*#R STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by 74..LS Aw(�Or✓ . On this !/ day of '�+9 S )NDRAE FORT ['� v i � Commission Number 759791 S„,Qk- Gr 3 yy'oTm's oo�Ires Notary Public in and for the State of Iowa 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). Signature of Police Ohjkf 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. :444 r/ Signat 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 cler midrivbadgeapp= 0 doc 09/2012 Iowa Department of Transporta(roll Free) 0tion office of Denier Selvices 515-244-9124 PO box 9204, Des Mdnes, lA 503W-9204 FAX: 515-239-183-f Inquiry Date: 11/16/2012 ID Status: Arthur, James Joseph Name: Address: 527 MEADOW ST City/State: IOWA CITY, IA 522455019 Mailing Address: 527 MEADOW ST Mailing City/State: IOWA CITY, IA 522455019 Certified Abstract of Driving Record DL/ID #: 043SS5374 (IA) Class: D Audit #: 6476952 Issue Date: 11/16/2012 Expiration Date: 11/17/2017 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 11/17/1950 . Sex: M History Information CLEAR DRIVING RECORD Customer #: 1639571 ID Status: None DL Status: VAL CDL Status: ' None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Name: Arthur, James Joseph DL/ID: 043SS5374 the cunt to I 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 Pursuant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby In the that am said office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify- said ertify Iowa this date: In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, l,� 11/16/20 12 g3�o�IOWA Vig:D. 0. T. �� 4 W .......... office of Driver Services Transportation 4��8� Iowa Department of Name: Arthur, James Joseph DL/ID: 043SS5374 'Dec. 10. 2012 4:48PM Div of Criminal Investigation No. 7639 P. 1/2 ' 12/09/2012 11:14 FAX 4 DCT TOR+, STATE OF IOWA Record Check Criminal lilsfory r r. R�equesC Form Fv: DCI Account Number! Tor Iew'a D1r1e100 of Criminal TrveedCadoo From: Mot S TOL 1 Support operat on: Bureia,16 Floor 215 E. 76 Street Dm MO1ate,l0wa 50319 �515J'ISSG (5151725400 Fat ebaae: ,(31q) 33$' Fail .• 319 551' Last Name (maisdAwN mos �r-14 oEH``lrth ,a.na:m Gender Data mmauo. 3tKltJ Sacur/i /PlumbG�r�y 46L,� rOIO �(J / L� KralVer lrtformatlonr Wldtoul a sign waiver wafror from the eobJect orthc rcqupe, a cpntpine erlmlaol blemry reeord may nre be tcluMDiq per Code orlowa, Chapter 692.2. For coImIeft pimlual bbloryrecord lolormatton, a allowed by law, alwa)t obnln �afrerel atorehomtheaobectolther opt. WdlverRelease)1Manbyeye paldWell oe�eo\or<4�11e9omcW ttduclnwwaim�l ellpaedtyf c�D.eolwhhdaAWime[l}imN.l 11"eKo a/:mtnCq• Aal'�`�Mxaydru iey,rol41Mm sinod die5llb� Rlu.cd . --—Walve►Signa[ ems- 77 -.. ,.--__ a a..a..... on..rri'f'heeYC RCSRYtS tp�t„y poly) D...:,,..! r;.,. Il.. 9 7A17 11.67AN Nn 6418 a 0 1 a search of ftprovided name and dare of birth reveslt:d; As of • r: N : r. Q No lows Criminal History Record found adtb DCI ',: -.. n I•rl2 History Record attached, DCI # A 0 N '� Iowa Criminal DCI Wtlalsv�— ->" F r N D...:,,..! r;.,. Il.. 9 7A17 11.67AN Nn 6418 lec.10. 2012 4:49PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00192705 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED - 2012/12/10 DCI:00192705 NAME 1 ARTHUR, JAMES JOSEPH 13011 SER RAC HGT WGT EYE HAIR SKIT POS 15501117 M 'W 511 190 HA2 BRO MED DC ADDITIONAL IDENTIFIERS CCH RECORD •^• 01 ARRESTED 19951014 AGENCY: IA0520200 IOWA CITY FD CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION SCHEDULE I TRK#: 007761701 .COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 POSSESSION SCHEDULE I / MARIJUANA TRK#: 007761701 SENTENCE DISP EFF DAT DEFE9RI'0 JUDGEMENT 19960208 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTZOATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NOM -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BVEDI N INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD C7HE SUBJECT OF YOUR INQUIRY. DN OF CRIMINAL INVESTIGATION No.1639 P. 2/2