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Home My WebLink About13-283 Authorization Number 1 (Office Use Only) somilifr APPLICATION FOR TAXI DRIVER CITY OF IOWA CITY (Police Department review must be made 410 East Washington Strcct between 8 a.m. to 3 p.m., Monday-Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name I/ (( )ii4t Middle n �� Last ,n 2. Mailing Address ' a q S 0 V l T� t- Ape_ i0(..4..-At C l t ` A 3. Telephone: Home / Other: I V g V G / 4. Prior experience in transportation of passengers: GI/V'-� 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? /V 0 Type of offense Where When 6. Have you ben convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Pi U Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? !V Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 71.10 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). (OVER FOR REQUIRED SIGNATURE AND NOTARY) clerk/taxidrivbadg 03/2013 ( P\--O 7/---S- I h y certify hat I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number appl� 6 . I understand that if I falsely answer any questions in this application, that this cation 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) r Signature of Applicant r ✓/ i%, Date I �_ I 0) STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by ��. o r Sv�1 . On this day of ,.._Subscribed aut: C {t�- ,tQ No ublic in n and fothe 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). Sign ure of P. c=rChief 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. (epi -7,4. ' • ,�� I ) Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 81/2" (width) and 51/2" (height)and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerkRaxidrivbadgeapp2010.doc 03/2013 Dec, 23. 2013 12: 26PM ,Div of Criminal Investigation KNo. 5336 pP. 1/1 t • :;a'ifr-,- , STATE OF IOWA e'==` ;v>„- I tri v n�1 Criminal History Record Check = ::::F I,7 Request Form '': DCI Account Number: y (T1applicable) - To: Iowa Division of Criminal Investigation prom: CITY OF IOWA CITY Support operations Fnreau,r Floor CITY CLERK'S OFFICE • , 215 E.7i1'Street410 E WASHINGTON STREET Des Moines,Iowa 40319 (515)725.6066 IOWA CITY IOWA 52240 (515)725-6080 Fax phone; 319-3565041 Fax; 319-356-5497 I am requesting an.Iowa Criminal History Record Check on: ' Last Name (mntdotot) First Name(mandatoa3à Middle Name(recommended) - M0P961iv M1L)i44 _ I L-4A1 Date of Birth(mandatory) Gelder(mandatory) Social Security Number(recommended) 1 .1S— P(Malo Qb'emale 3 r i t ('7 V —6671 Waiverinformation:Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history record Information, as allowed by law,always obtain a Waiver signature from the subject of the request. Waiver Release:Thereby give permission for the above rcqucaling ottidal to conduct an Iowa criminal history record eheek with the Division of&iminel Invesllgatlon(DC1). Any criminal history data conoemingme lhatis einlellnneed by the DCI may be�eleased as allowed bylaw. Waiver Signature: /L `r, % �I�i1L _ .,, . . . Q IowaCriminalHistory Record Check Results (Dante only) M of 22.--023 --f3 , a search of the provided name and date of birth revealed; No Iowa Criminal History Record found'with DCI 0 Iowa Criminal History Record attached,DCI# /C DCI initials S.( J • Received IisenD`try I,J.4013 1 :35PM No. 4880 NORTH CAROLINA DIVISION OF MOTOR VEHICLES RDLSI/DRIVING RECORD CHECK REPORT TYPE:FULL NON—CERTIFIED REPORT DATE: 12-16-2013 NAME: MORGAN MICHAEL ALAN ADDRESS: 3953 WINDS RIDGE DR CITY: WILMINGTON STATE: NC ZIP: 284094625 TOTAL POINTS: 0 DOB: 09-06-1975 HEIGHT: 6 FT. 01 IN. SEX: M EYES: BRO HAIR: BRO RACE: W PRIMARY LICENSE NO: 31368549 SECONDARY LICENSE NO: NON—RESIDENT MILITARY: N ORIGINAL ISSUE DT: 11-15-2011 OS DL NO: 0630615451 OS STATE: IN *** DRIVER LICENSE STATUS: CLS C ACTIVE *** LIC LMT COND CLASS GRP TYP ISSUE DT EXPIR DT CDL DISQ PROB PRIV RESTR STATUS C D 09-10-2013 09-06-2019 N N N N N ACTIVE ENDORSEMENTS: RESTRICTIONS: 0 CRD TANS: 0009592712 OCCUR/ CONV/ BEGIN DATE END DATE NATURE OF RECORD OR DIVISION ACTION POINTS 09-18-2012 09-06-2019 DUP ISS: CLS C EN: RS:0 11-15-2011 09-06-2019 ORG ISS: CLS C EN: RS:0 10-17-2011 09-06-2019 ORG ISS: ID EN: RS: WITHDRAWALS NO WITHDRAWAL DATA TO REPORT CONVICTIONS NO CONVICTION DATA TO REPORT ACCIDENTS NO ACCIDENT DATA TO REPORT vox * * END OF DRIVING RECORD * *