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Home My WebLink About13-275 Authorization Number 1 ) i r 1 (Office Use Only) CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington Street between 8 a.m.to 3 p.m., Monday—Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First d le La 1. Name G ( 1 � r;iLas "‘J/'�, 2. Mailing Address�/ 57 P .LQ*c% -J-tI 3. Telephone: Home -5/0' 930-9 92_ Other: 3t1?—S-1 ---4(.5-4 4. Prior experience in transportation of passengers: el e PlYANS C"' ', 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsevbhere?,e► .• 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? t\ (, Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? I e 4Cj Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? U 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) clerkttaxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number • //5K/I- L��,f C� . 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 Applicant `139 42109t19.., Date / L �i 13 STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by g(iceV1 C. t -�L>rP S . On this l - k day of � aa'�`,� WENDY S.MAYER otary Public i(I 9nd for the State of lob 9,*; ! Coni."sa;un Number 72941* • xc • My Commission Expires low . ')—)��j10 ************************************************************************************************************************************************ 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). / 2/b p 3 ignatu of Police Chief or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. 1J- 1P-13 - Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/z" (width)and 51/2" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp201 0.doc 03/2013 , Iowa Department of Transportation Or Office of Driver services (Toll Free)800-532-1121PO HoX.9204,Des Moines,IA.503 -9204 515-248-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 11/15/2013 DL/ID#: 713XX2989 Customer#: 3293899 Name: Matthes, Brian Gene Class: 0 ID Status: VAL Address: 2128 S RIVERSIDE DR LOT Audit#: 2723782 DL Status: None 130 Issue Date: 11/05/2008 CDL Status: None City/State: IOWA CITY, IA 522465854 Expiration Date: 11/05/2013 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 2128 S RIVERSIDE DR LOT Restrictions: NONE Restriction None 130 Date of Birth: 8/16/1971 Supplement: Mailing City/State: IOWA CITY,IA 522465854 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR ___.............. ...... _....-,..._._........ ...... ._ ___�__ .. ._..,_..,:_ W....._ __ ---- 06/19/2002 10/09/2002iA20 Operating While Intoxicated Johnson IA 09/19/2002 08/12/2013 :09/10/2013 852 1 No Driverr'sOperating VLicensee toxmated :Johnson IA e -TJohnson :IA 1 Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation JUR 06/19/2002 A90 • OWI Test Failure :IA ..3 09/19/2002 :A90IOWI Test Failure ;IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR iRevoked 06/30/2002 12/27/2002 iA90OWI Test Failure 'IA IIA _ Revoked . . X09/30/2002 `09/30/2003 #A90 :OWI Test Failure ,IA ;IA , Name: Matthes, Brian Gene DL/ID: 713XX2989 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: a`itElClf��"�: ,or p04,11::�... .l yy 11/15/2013 4: IOWA .SS ,. D. O. T. g �'' 1 " • • ' ' Office of Driver Services . hrrnn.%a Iowa Department of Transportation Name:Matthes, Brian Gene DL/ID:713XX2989 Nov. 27. 2013) 2:41PM,t Div of Criminal Investigation No. 6638 P. 1 i ,• u. eu i3 'U.v u4 vl ty Vleln bl ty vi xuwa t,I (y Ivo. qND r. ii? • .rte:, STATE OF IOWA - `;g, iv, Criminal History Record Cheek / :' Nt :.,1c lgvin All o; -c:yk.�? <��' Request Form '�, -, ..1:q r3- �71vO l 1 . EA'�i;�" I' DCTAccountthmber: I— •-•'� (I applicable) • To: Iowa Divblen of Criminal Investigation From: CITY OF IOWA CITY Support Operations Bureau,la?~loor 61Tt CLERIC 9 O'FFICE 215 E.7th Street 410 E WASHINGTON STREET Des Moines,Iowa 50319 (515)725-6066 IOWA CITY IOWA 5224io (515)725.6080 Irax mono; 319-3565041 Bax: 319--356-5497 Tam requesting an Iowa Criminal History Record Check on: Last Name (mandatory) _,ltirst Name(mandoory) Middle Name(recommended) in a(HA eS Sillh 6 ri. e Date of Birth Gender(mandalory) Social Security Number(recommended) 4 - 6 - -- /Q71 OMale b)?emale 4 n-2-1°1-‘ Waiver information:Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692.2.1'or complete criminal history record information,as allowed by law,always obtain a waiversignalgro from the subject of the request. . WaiverlteieaSe:Thereby give permission forthe abovo requesting ofFrcialto conduct an Iowa criminal history recent checkwith the Division of Criminal Invectigetiotl(DCI). My criminalhhlorydalaconcemingmottlathmainlainedbytheDCImarbereleasedeoallowedbylaw. WaiverS5gnature ' V Xowa Criminal History Record Check Results (DOluse only) As of I \—2.-1- l , a search of the provided name and date of birth revealed: i ❑ No Iowa Criminal History Record found with ACI SI, Iowa Criminal History Record attached,DCI# (/Ll 0 / y DCI initials Received Timel7Nov. 25. 0:2013 10:00AM No. 6154 Nov. 27. 2013 2:42PM Div of Criminal Investigation No. 6638 P. 2 IOWA CRIMINAL HISTORY DCI 00645874 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/11/27 DCI:00645874 NAME: MATTHES:BRIAN GENE DOB SEX RAC HGT WGT EYE HAIR SKN POB 19710816 M W 601 325 GRN BRO FAR IA ADDITIONAL IDENTIFIERS TAT R ARM CCH RECORD **t 01 ARRESTED 20010604 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401(5) POSSESSION CONTROLLED SUBSTANCE I TRK#: 100259301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124,401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCR059018 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100259301 SENTENCE OISP EFF DAT DEFERRED JUDGEMENT 20011214 PROBATION 1Y 20011214 REVOKED 20021029 02 ARRESTED 20020619 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OPERATING WHILE INTOXICATED • TRK#: 100578601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / 1ST OFF COURT CASE ID: 06521 OWCR062458 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100578601 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 20021009 FINE $1000 20021009 03 ARRESTED 20020919 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 100664701 Nov. 27. 2013 2:42PM Div of Criminal Investigation No. 6638 P. 3 • DCI 00645874 PAGE 2 OF 2 COURT DISPOSITION AGENCY: IA052015,1 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J,2(A) OPER VEIL WH INT (OWI) / 1ST OFF COURT CASE ID: 06521 OWCR063353 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100664701 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT SUSPENDED JAIL 230 20021230 JAIL 300 20021230 FINE $1500 20021230 PROBATION 365D 20021230 REVOKED 20040209 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 DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD XS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. r DIVISION OF CRIMINAL INVESTIGATION 1 J\