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Home My WebLink About13-249 r Authorization Number /3— a `i _ i (Office Use Only) f__.® .2. room Air APPLICATION FOR TAXI DRIVER CITY OF IOWA CITY (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 Middle Last 1. Name G'; )/Qv-r 1 A-L2 2. Mailing Address I.1C lis C cc.,,r; 3. Telephone: Home Other: 4. Prior experience in transportation of passengers: 7;;,,c; ��,� cd - 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere' Y` v1/d Type of offense Where When 1;;:y; 1,`0 iiia - AfAt- 0.142 9-2r ry 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ,/i4 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/i9 .��/�7 c .I %� C69.4 ��-a- ‘81.1k' ]S;S:r_ } 1,c, r-17,\. )/-7 4 .:w 81.1 'in.: [),Zt w _r 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? //d 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) • clerWtaxidrivbadg 03/2013 r I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number Jl;;1'7 uv /,n/o,1 . 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, 14+4, Date/(---/51/43 ************************************************************************************************************************************************ STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to efore me by c—,', Ibq.e , -P1.ti-�\ 0 . On this I 2tL day of .4 . A.. .e �vilk WENDY S.MAYER rotary Public in@ d for the State of .�a cu..Nur, .72,428 ` � My Commission Expires ow 'l —) 3-11 ************************************************************************************************************************************************ 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). Signa ure o.- 7olice Chief or designee D t 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. 2/(re_ef‘ez2.- L. ie - Z-tL /n/l b /l A SignatCity Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 5'/z" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update derkAaxidrivbadgeapp2010.doc 03/2013 I+I% Iowa Department of Transportation Office of Driver Services Nadi Free)800-532-112121 PO Box 0204,Des Moines,IA 50306-92114 515-244-9124 FAX 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 10/18/2013 DL/ID #: 627XX6064 (IA) Customer#: 2375713 Name: Phelps,Gilbert Allan Class: A ID Status: None Address: 1206 E COURT ST Audit if: 4423124 DL Status: VAL Issue Date: 06/10/2010 CDL Status: VAL City/State: IOWA CITY, IA Expiration 05/14/2015 CDL Cert None 522403234 Date: Status: Endorsements: L CDL Med None Status: Mailing Address: 1206 E COURT ST Restrictions: Corrective Lenses Restriction None Date of Birth: 5/14/1958 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522403234 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 08/19/2011 109/21/2011 1M14 ;Fail to Obey Traffic Sign/Signal Johnson 02/05/2013 102/25/2013 7S92 ;Speed (10 mph &under in 35-55 mph zone) ;Buena Vista ;IA I Name: Phelps,Gilbert Allan DL/ID: 627XX6064 Pursuant to Iowa Code §321.10,1, 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: y -y Atte.'' .4• \ 10/18/2013 MY IOWA :'% e %3 :D. O.T. s � s . ,in � < Iowa D partme tOffice of DrivereofiTransportation Name: Phelps,Gilbert Allan DL/ID: 627XX6064 ✓ Sep. 27. 2013 9:43AM Div of Criminal Investigation No. /484 F. 1/1 r , �r • ■ ■ 1 - STATE OF IOWA ••••••.,-.•= �• '%;,,, Criminal Ristory Record Check• +"'szi . Yee nest Form • DCI Acc000tNumber:9967-F ' • artnneist.) To: Iowa Division of Criminal Investigation From: Yellow Cab of Iowa City Support Operations Busty InFloor . 215 E.71 Street P.O.Box 428 Da Melon,Iowa 50319 Iowa City,IA. 52244 (515)735.6066 (sib)725.6080 Fax (319)9384777 . - Pbom: Fuc (319)339.7302 I am requesting an Iowa Cr(miadiiismry Record Chock ons Last Name(tummy) ' First Name(m.cass,,y)'• ' Middle Wume pemmmmded) • • Stir (r ll av: • , A• Date of Birth em.et wy) . Gender(m.siuy) Soctal•Soeurity Number(taws cadre) _ S-/9-19S1 • a-1,t ff ic9S e -• • • IZINlale OFemale .isze•9v-nib h Waiver Information:Without a algued weaver from the subject of S regatta;a tomes r,riminpl history record may not he releasable,per Code of Iowa.Chapter 692.2.For complete criminal Iibtory.record.information,w allowed by/am,always ' obtain a waiver s{glare from the subject of the request, • Waivrr Rdeasa.amity gris pasabsioa Swat shwo airmoiaa officio to:Cohan lownototon Meow marl/theca withereDivScaofQialnl 1nMdl.dmtf-Any o)mwibbcaydawnoanlhgme'ha limataittedbydsDCI mei troalma aalonoabylaw • • WaiverSignatarkrtt glPli . . . ' • _ . • •// IJowa `Criminal Elston Record Check Results „naoy,) As of g ill l ` 13) ,a search of the provided name and date of birth sweated: ; ‘..Er. No Iowa Criminal History Record found with DCI • • ❑ Iowa Criminal History Record attached,Da# • • DCI initials _ • DCI-77(08/25/10) Received Time Seo. 23. 2013 4: 12PM No. 8758