The URL can be used to link to this page

Home My WebLink About13-240 T Authorization Number I J �� L _ i (Office Use Only) CITYmoo ognir 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 Middle Last 1. Name /I?(1\9 4/76/(i///J �(i 0a/e/,71 2. Mailing Address ��r? ,e/k�Gi/0001 /9l1.,r/ Sol 44 2 CQyAc1Y R-C(t)tck �r-\ 522-tGi 3. Telephone: Home l ;2,02) 3(c)\ -2 7 3 } Other: 4. Prior experience in transportation of passengers: /3 yect -S-- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? I/(i Type of offense Where When -7.01‘x So y.•s..v (,, 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 () w lOJC 7. Have you been convicted of any traffic offenses in the last five years? Y fi • Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Al O 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) cleNtaxidrivbadg 03/2013 t t I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number rj/Z1,4 G Li 6 g4,' . I understand that if I falsely answer any questions in this application, that this application may e 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 D�4 Date 7 /(4/��3 STATE OF IOWA ) . COUNTY OF JOHNSON ) ) ,�/' ` n bs rbegand sv�Qrn to before me by �( YiC`-a_ I T 0 fit/YVn . On this day of L `-� c , ---0 A-,<., ,-6 e' k/---T.:77/-/-e„ ,''4 s� KELLIE K.TUTTLE Notary Public in and for the State of Iowa - ^^y issio res .5 ill ************************************************ * **** **************************************************************************************** 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). "14 _____ Signature Police 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. // CGf ce-Lt� tit/ /C ._ "7/ - /3 Sign re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2"(width)and 51/2" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update cerklt* idrwb3dgeapp2D1o.doc - 03/2013 a r Iowa Department of Transportation Or:. Office of Driver Services (Toll:Free)301-532-1121 PO Box 9204,Des Moines,IA 50308-9204 515-244-9124 4111111110 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 9/18/2013 DL/ID#: 514AG4590 (IA) Customer#: 5820067 Name: Mohammed Class: D ID Status: None Abdalmoomen, Elhag Abdallh Address: 50 66TH AVE SW APT 4 Audit#: 6916592 DL Status: VAL Issue Date: 05/03/2013 CDL Status: None City/State: CEDAR RAPIDS,IA Expiration 01/25/2016 CDL Cert None 524045349 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 50 66TH AVE SW APT 4 Restrictions: NONE Restriction None Date of Birth: 1/25/1981 Supplement: Mailing City/State: CEDAR RAPIDS,IA Sex: M 524045349 History Information Convictions Citation Date Conviction Date AO Explanation _ County TUR -t 01/21/2012 '03/01/2012 594 (SpeedWV Name: Mohammed Abdalmoomen, Elhag Abdallh DL/ID: 514AG4590 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: ....yy 'vE R D o, e• . �O0, 9/18/2013 ; gt CaLitstA soy...••••••'S Office of Driver Services %%Z."DIVERs' Iowa Department of Transportation Name: Mohammed Abdalmoomen, Elhag Abdallh DL/ID: 514AG4590 ''14 Sep. 20. 2013i 4:25PM1 Div of Criminal Investigation No, 8574 P. 1/4 ,. . .' �� miry vi 10V4 �itY it'e, 37UL . P. I Y l , rne,��},ti9 Criminal History Record Ozeck .,' at 4 '1 K. e J • '� �' Id's i�e�Tl[e9t Form v�� • f' J er tpli DCI Account Number: II Goa - (Itapplicablo) To, Iowa Division of Criminal Investigation From; _City of Iowa City Support Op orations Bureau,1i°poor City Clerk's Office 215E.7th Street 410 E.Washington Street Des monies,Iowa 50319 (515)725-6066 Iowa City, IA 52240 • (515)725.6080 Fax Phone: 319.356.5041 Fax: 319-356-5497 • I am requesting an Iowa criminal}Xistoly Record Check on: Last Name (mandatory) First Name(mandatory) Middle Name(rceommeadeci) Date of Birth(mandatory) Gender(mandatory) Social Security Number(recommended) 0// --5//q ( EliVrale °Female 541g L/ '4- 1 /3 WaiverInfolmation:Without a signed waiver from the subject of rho request,a completee criminal history record may not be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history record information,as allowed bylaw,always obtain a waiver signature from the subject of the request. Waiver Release;Ihcreby eye permission forth:above requesting official to conduct an Iowa criminal hltmry record check with rho Division bf Crintfoal Investigation(DCO, Any criminal History dam concerningme that Is mainralne, 'y the DCI may be released as allowed by taw. Waiver Signature: ', .J�'I , Iowa Criminal History Record Check Results (DClusconly) ( As of _1`�-C�`\3 • ,a search of the provided name and date of birth revealed: • 0 No Iowa Criminal History Record found with DCI • ri Iowa Criminal Bistwy Record attached,DCI# C1LA9C 0k) • DCI initials . •ieceived TLme�Se1y. 78.1013— 1 :53PM—No, 6532 Sep. 20. 2013 4: 25PM Div of Criminal Investigation No. 8574 P. 2/4 • IOWA CRIMINAL HISTORY DCX 00948263 NON CONVICTION PAGE 1 OF 1 DATE PRINTED- DCI:00948263 2013/09/20 NAME: MORA[MED,ELHAO AEDALLH non SEX RAC MGT WGT EYE HAIR SRN POB 19810125 M B 507 160 BRO BLK MED YY ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 20120122 AGENCY: IA0570100 CEDAR RAPIDS PD CHARGE NO- 01 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / 1ST OFF TRK#: 5A00FRV01 COURT DISPOSITION AGENCY: IA057015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / 1ST OFF COURT CASE ID: 06571 OWCR097131 CHARGE CLASS: NON CONVICTION TRK#: 5A00FRV01 DRUNK DRIVING SCHOOL SENTENCE DISP SF? DAT DEFERRED JUDGEMENT 1Y 20120518 PROBATION 1Y 20120518 DISCHARGED FROM EXPUNGED 04/08/2013 20130408 DEFERRED JUDGEMENT AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. 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 ACS. IN THE ABSENFF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS AC BASED ON TNF ION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION