The URL can be used to link to this page

Home My WebLink About13-270 ' ` Authorization Number I?i -,.2 `1 4-) _ 1 (Office Use Only) .14 We 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 Fi stMiddle ,4as 1. Name �� e`C (met--c- 2. Mailing Address � 1),p 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: Z`(�� ` — )\X 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 'f 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 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When fur-(.\ —CO 0 `( 5� -�1�',- - - t` �' SLA 1-)C1 C-0 8. Has your driver's license or chauffeur's lic nse been suspended or revoked in the last five years? pa 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 - s I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number E)11 PP 1 (7-5 . 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 _ Date STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by e.04 et1-L G , . On this ‘21_,p4-1.4 day of J7 )t 14Q,c- ?CTD/3. C 0.914/,- WENDY S.MAYER - —J-- A. - - Commission Number 729428 Nota WWalic in an.lfor the State of o wa ty!J,, My CLrnnnasivrr Ex}nros i 'OW - 1 Le 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). /1--02 t--/p? Sig : ure of P./c: Chief 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. Airw_ey4i___„ L./ e 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 clerk/taxidrivbadgeapp2010.doc 03/2013 11/26/2013 13:35 Yet low Cab of Iowa City (FAX)3193382708 P.002/002 Iowa Department :of Tra,ns,portation Office of DriGer.Sentices' '1 tTdf Fro4B00-532-1121 PO Boot 9204,Des MGines;1A.50306-9204 .515-244-9124 .FAX:;•515-239-1837 Certified Abstract of Driving Record Inquiry Deers 11/19/2013 oL/lo m BSIPP8357(IA) Customer 1: 222201 Name: Cady,Robert Genet!' claw 0 10 Statusr None Address[ 31 PONDVIEW LT Audit 111 6255286 DL!Return VAL Iine Deter 00/29/2012 CDL Status[ Nona City/Stater IOWA CRY,IA 322403022 Expiration Data: 07/29/2017 COL Cart Statue: Nona endorsementai 3 CDL Med stttusi None MAllin9 Address: 31 PONOVIEW LT Restrictions) Corrective Levies Restriction None Data of Binh: 7/29/1952 eupplementr Mailing City/State, IOWA CITY,IA 322403020 Sax: M • History Information Convictions Citation Date Conviction Data ACD explanation County JUR 12/31/2008 l01/2en009 JM14 to ObeyTraffic Sign/Signal ISohnson hA Accidents•Accident Involvement Indicated does NOT mean the Individual was at fault or given a citation. Accident Dete_ Case Number IUR 03/19/1013 ^731600 j1A Nemel Cele,Robert Gine IR tat/ro:011pp6357 Pursuant to Iowa Code 021,10,I,Kim Snook,Olrecter of Office of Driver Services,low.Department of Transportation,do hereby certify that I am the custodian of the retards held by the Orrice or Driver Services,that this Is a true end accurate copy of an official record currently in the custody of Bald office,and that I have been authorised by the Director of the Iowa Department ofTrenaportailon to so certify, In witness whereof,I have caused my signature end the soul of the Department to be set upon this document,at Ankeny,Iowa this decal ,II OWAN 41E4t rrhr, 11/19n013 0. Cirepete Clesoroul€ INy�`''Bi&% Office of Driver Services Lows Department of Transponeaon Noma,Cady,Robert Gene III OL/for e1IPP0337 Nov. 25. 2013 3: 14Pt� Div of Criminal Investigation No. 6312 P. 1/1 "r,V�. I/• L V I J I I •T J,V, V i t r V I C I a VI .. uv I it u, a V:) L y II V, 9 I[f I. MCP STATE OFIOWA r ;2 `ri !\', Criminal History Record Check "2%-', -. i ' �;'�, I .'equest Form a ,i,:o•'> • DCIAccountNumber: tinh -r (if applicable) • To Iowa Division of Criminal InvestigationIFrom; CITY OF IOWA CIaY Support Operations Bureau,Id Floor CI't? CLERIC'S OFFICE 215,E,7'h Street 410 E WASHINGTON STREET Des Moines,Iowa 50319 (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 Cheek on: ' Last Name(mandaon8 _ First Nexus(mandatory) Middle Name(recommended) Date of Birth(mandatory) _Gender(mandatory) - Social Security Number(recommended) O %Male (]Female To "(4,1.01 llivaY r ,nnatior:Without a signed waives'from the inflect of the request, a complete criminal history record may not be releasable/per Code of Iowa,Chapter 692.2.For comuleiq criminal history record information,as allowed by law,always obtain a waiver signature from the subject of the request, Waiver Release:Ihcceby g(vo ponoiaaron for the above requesIing offlolel to conducten lova yr;mind hlsloryrecord cheekwith theDivicion of CrimInel Investigation(DCI). Anyorlminel hisloty dale concerning me lit atis maintained by the DCI may be saluted as allowed bylaw. Waiver Signature: f<3 t (/ a— Iowa Criminal History Record Check Results (DCluro only) As of I ) '?513 , a search of the provided name and date of birth revealed: tNo Iowa Criminal History Record found with DCI El Iowa Criminal History Record attached,DCI# DCI initials co Received TiyNoz;,1J94013 11 :41AM No, 2541