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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(/ Middle -7 La§t
1. Name �4!/1 Y6'l l C.
2. Mailing Address w F-0 d �
3. Telephone: Home .-( ( - b I Other:
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4. Prior experience in transportation of passengers: 4'7: - )q 714 1Czx I Ca i i3G i`T-{k_tt. Ni f t'S±
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5, Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ye
Type of offenserr��// ((�� nn Where When
M���Ciol•ecarta;� (�r C� 1v'ke L '011) e.fs('.ctiC�t[°Ciltl�t(
6. Have you bgen 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? IES
Type of offense Where When
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8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? AJO
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)
11
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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)
•
Gerk/taxidrivbadg 03/2013
I
herebyI certify that I lve issued to me by the Iowa Department of Transportation a valid Chauffeur's license number
(9aC . 01 S . 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)
//11 / / ----77Signature of Applicant �t��y_._ is, .� _ Date /0 ' J� /
- /-__--
*******;:*******************************************t:**************.,********.,.**************.,,.,*********************************************,.***
STATE OF IOWA )
COUNTY OF JOHNSON ) I
sscri ed.and sworn to before me by C., / ) L1i c ft - . On this 1--1- day of
b ")z) lc-DCr, 2 )i3 / ---
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:ti IA/4, KELLIE K.TUTTLE F (/ - l �'.r f (�"� ,
Commission umbe 221819 otary Public in and for the State of Iowa
Mi L1 alon /z>nies
tow.
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).
7
Signat e of Chief or designee Date
99
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.
—21 tl�Gut1-h, 1-e • e�.✓ /l `/ " / 3
Signature of City Clerk or designee Date
Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 5 72"
(height) and prominently displayed to all passengers.
************************************************************************************************************************************************
Office Use Only
Approved application
DCI report
State certified driving record
Website update
GerkRaxidrivbadgeapp2010.doc 03/2013
(84P. 27. 2013 .10: 56AM ,Div of Criminal Investigation No. 7504 P. 1/2
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Received Tim `ep. 27. A.20131010:24At)No. 93110tad,DOZ$ 1411x64)— ,
Sap, 27. 2013 10. 56AM Div of Criminal Investigation No. 7504 P. 2/2
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,rIOWA CRIMINAL HISTORY DCI 00442642
j MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1
DATE PRINTED-
2013/09/27
DCI:00442642
NAME: NEVEU,ROBERT GEORGE
DOE SEX RAC HGT WGT EYE HAIR SKN POB
19531013 M W 600 152 HAZ BRO FAR WI
ADDITIONAL IDENTIFIERS
SC L PT
CCH RECORD wwv
01 ARRESTED 19920710
AGENCY: IA0520100 CORALVILLE PD
CHARGE NO- 01 IA STATUTE IA714-1
THEFT 1ST
TRIO: L42244501
COURT DISPOSITION
AGENCY; IA052015J JOHNSON CO DIST COURT
COUNT NO- 01 IA STATUTE IA714-7
OPERATING W/O OWNER'S CONSENT
CHARGE CLASS: MISDEMEANOR CONVICTION
TRK#: L42244501
SENTENCE DISP EFF DAT
SUSPENDED PRISON 2Y 19920929
CREDIT 81 DAS
PROBATION 2Y 19920929
COURT DISPOSITION
AGENCY: IA0520150' JOHNSON CO DIST COURT
COUNT NO- 02 IA STATUTE IA724-2-3
THEFT 2ND
CHARGE CLASS: STATUS UNKNOWN
TRK#: L42244502
SENTENCE DISP EFF DAT
SUSPENDED PRISON 2Y 19920929
CREDIT 81 DAS
PROBATION 2Y 19920929
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 AGEN BY THE DCI.
IN THE ABSENCE ERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS
BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD •
COVERS THE SUBJECT OF YOUR INQUIRY,
DIVISION OF CRIMINAL INVESTIGATION
i
Iowa Department of Transportation
Office of Driver ServicesOr (foil Free)800-532-1121PO Box 9204,Des Moines,IA 50308 92124 515-244-9124
fIIIIIP FAX:515-239-1837
Certified Abstract of Driving Record
Inquiry Date: 10/4/2013 DL/ID#: 199CC0154 (IA) Customer#: 4596181
Name: Burke, Cynthia Anne Class: D ID Status: EXP
Address: 1310 FOSTER RD APT Audit#: 7335106 DL Status: VAL
203 Issue Date: 09/12/2013 CDL Status: None
City/State: IOWA CITY,IA Expiration 10/13/2018 CDL Cert None
522451594 Date: Status:
Endorsements: 3 CDL Med None
Status:
Mailing Address: 1310 FOSTER RD APT Restrictions: Corrective Lenses Restriction None
203 Date of Birth: 10/13/1953 Supplement:
Mailing City/State: IOWA CITY, IA Sex: M
522451594
History Information
Convictions
Citation Date Conviction Date ACD Explanation County 1UR
08/09/2012 09/05/2012 N63 Driving Wrong Way on One Way Street Johnson IA
Name: Burke,Cynthia Anne DL/ID: 199CC0154
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:
*E11!C(f a ly,
Are/ •.pay 10/4/2013
et
: IOWA -tot/6 _be
v 0c 0.T.; r 4017 eie.004
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4„4,.......S Office of Driver Services
1‘` mutt� Iowa Department of Transportation
Name: Burke, Cynthia Anne DL/ID: 199CC0154