The URL can be used to link to this page

Home My WebLink About13-259 Authorization Number t3 —67 _ 1 (Office Use Only) "It IMO 11111117 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 Firs1. Name KEOC} Lomas 2. Mailing Address 7. a '2 t (2)3 , L)E_ ►F . 52755- 3. 27553. Telephone: Home Other: 3 t`21 -4,2 3 H I Z 47 4. Prior experience in transportation of passengers: eY01) "f-� S 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? N 0 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? SOD Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 'IF Type of offense Where When 6?EED 6 -6 -1012 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 1•31) 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) No 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) clerWtaxidnvbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number C C 2`1(p . 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 or Date �'� �' 13 STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by Key( qth LD,ti-k rc) . On this C ^ day of WENDY S.MAYER Nota Public forthe State o Iowa Cei ,s,vr,Nurnoer 72b'4j. My Commission Expires ?3 .. tF ************************************************************************************************************************************************ 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). //I�� 3 Signature of olice Chief or designee ate 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. . ate I !/ ll. Signat of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/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 deridtaxidrivbadgeapp20l0.doc 03/2013 i ip Iowa Department of Transportation Office of Driver Services croft Free)800-532-1121 ?O Box 9204,Des Moines,IA 50306-9204 515-244-9124 411111. FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 11/8/2013 DL/ID#: 082CC2468 (IA) Customer#: 2931188 Name: Lathrop, Kenneth Dean Class: A ID Status: None Address: 4763 HWY 22 NE Audit#: 4033375 DL Status: VAL Issue Date: 01/21/2010 CDL Status: VAL City/State: LONE TREE,IA 52755 Expiration Date: 12/22/2014 CDL Cert Status: None Endorsements: T CDL Med Status: None Mailing Address: PO BOX 183 Restrictions: Corrective Lenses Restriction None Date of Birth: 12/22/1967 Supplement: Mailing City/State: LONE TREE,IA 527550183 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR _ 05/08/2012 06/06/2012 . 592: Speedm___- _ �__ Polk IA Name: Lathrop, Kenneth Dean DL/ID: 082CC2468 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: en .z v C�• ..4\ 11/8/2013 slit trIOWA %.S% a :D. O. T.A.,..r ,I,hfOF'••••'••S`c"`' Office of Driver Services ��`mu:, �" Iowa Department of Transportation Name: Lathrop, Kenneth Dean DL/ID: 082CC2468 ° OF Pael� State of Iowa P OF,x,49 tt ��`� r^� Division of Criminal Investigation 5V �Q 9� 215E7`hSt `° ` t° 5 IOWA Des Moines IA 50319 ,00 Ph.515-725-6066 Fax 515-725-6080 2 ' .%,0".,,.."" ' ,off ,c 3 O4.,C. " .�.,. o'CT/ON p\-- Iowa Criminal History Record Check "�yINA�� Walk-In Request Your name k£ ak i D'>) Lfl 1 Address P. c7 . l 93 City/State/Zip Lcc.y,_ i ekt. , =oc,vA, 52155 Fill in all shaded areas. Phone# ^3\Q - (031- 4217 Requesting an Iowa criminal history record check on: Last Name Apellido(mandatory) First Name Primer Nombre(mandatory) Middle Name Segundo Nombre(recommended) Date of Birth Fecha Nacimiento(mandatory) Gender Genero(mandatory) Social Security Number (recommended) 1. - ..2._- i �� Male ❑Female qg j-02-11/5-9 Waiver Signature Firma(If th equest is on yourse f,please sign. If the request is on someone else,write N/A.) ei,7771/Av:(6 , 1 7/ Results DCI USE ONLY As of \1\--11 , a name and date of birth check revealed: tV \ No record found -f ... 1c ,:Jrr. El Record attached, DCI# r- - -r, = 147 DCI initialsw _ N Receipt Number of requests I x $15.00 per last name=Total amount$ 1 5- 00 Method of payment: VI cash ❑money order ❑check# ❑MasterCard or Visa Cardholder's name Last 4 digits of MC or Visa DCI initials Cer- Credit Card Number# Exp. Date