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Home My WebLink About13-234 Authorization Number /i — 3 • 1 _ 1 (Office Use Only) wrlgaice; 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 Las 1. Name ,Pa v i cQ /1Of 4 J 08rnc r-- 2. Mailing Address (917 Li/y2 S0Q St [To— Sag'17 3. Telephone: Home 319' y3 4. j,2 Other: 4. Prior experience in transportation of passengers: 7 s- i j vilAct 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 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? e'.42.&. Type of Offense / Where When S �/� h�t� cc. r lLt,L /` 7. Have you been convicted of any traffic offenses in the last five years? ti r Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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) /1Y 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) clerknaxidrivbadg • 03/2013 r I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number . 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 J c . '7C Date A/- V "-/-1 • STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by` f/jc/ gZ kc /d ,'- z.e-i..9 . On this 'j,z day of iPe-',A2e,J- .,;/)/3. • --4-"/ ) -01,4-‘4,e-“--) `-v - `SLG �/ Notary ublic in and for the State o owa ************************************************************************************************************************************************ 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). ,' :► J 1 /0- 9 Sign ure of Pr C Chie 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. AQ' -e-a•av 7e ,„..) ignau ��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 derMaxidrivbadgeapp20 i 0.doc 03/2013 Iowa Department of Transportation eilli# Office of Driver Services (Toll Free)800-532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX.515-239-1837 Certified Abstract of Driving Record Inquiry Date: 10/3/2013 DL/ID #: 127AC6033 (IA) Customer#: 1934738 Name: Toomer, David Alan Class: D ID Status: EXP Address: 2742 500TH ST SW Audit#: 4671306 DL Status: VAL Issue Date: 09/14/2010 CDL Status: None City/State: KALONA,IA 522479214 Expiration 09/21/2015 CDL Cert None Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 2742 500TH ST SW Restrictions: NONE Restriction None Date of Birth: 9/21/1956 Supplement: Mailing City/State: KALONA,IA 522479214 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 01/24/2009 02/11/2009 :M14 - [Fall to Obey Traffic Sign/Signal 'Johnson IA Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 01/15/2009 ._,. .. _ ..._....,.. .......____. .__... 488782 ___... _._......................___. ...... 'IA 07/23/2011 ,641185 ;IA Name:Toomer, David Alan DL/ID: 127AC6033 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: 3.t ................ 10/3/2013 ( Ctf;i ,''1 jC`9/O ..... IowaeDepartme Department Transportation Name:Toomer, David Alan DL/ID: 127AC6033 , 80 4.0 1. L2013 4: 23PM ,..Div of CriminalrIInvestigation NNo. 7768 P. 14 frl'k STATE OF IOWA wiski , ;n41/4.). Criminal History Record Check i . 1c /Iumb ;; e 1- 'AL: Request Form . ininnic DCI Account Number: loom" F (if applicable) To; Iowa Division of Criminal Investigation From: CITY OF IOWA CITY Support Operations Bureau,In Floor CJS CLERK'S OFFICE 215$.7rh Street 410 E WASHINGTON STREET Des Moines,Iowa 50319 (515)725.6066 IOWA CITY IOWA 52240 (515)925-6080 Fax Phone: 319-3565041 Far: 319-356 -5497 I am requesting an Iowa Criminal history Record Check on: _ Last Name(msndatory) uirst Name(mandatory) Middle NA`me(recommended) • ' 601n-ex _ DA✓1i 77 'an Date of Birth(mandatory) Gender(mandatory) Social Security Number(teconmwnd;d) 9-d1-SL ErMale ❑Female I- ?e,278- 6902.5 Waiver Information:Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692,2.lror combat criminal history record information)as allowed by law,always. obtain a waiver signature from the subject of the request, Waiver Release;mthereby give pemnsslon for the above requesting oulota%to conduct an Iowa criminal History record check with Iho Division of Criminal investigation(DC1). Any criminal history dale concerning mediet laralntelpd.b rho Delrnayberelenreduellowedbylaw. C -Ti::. . Waiver Signature: . Jd/. r _Pad . — . . , _,,I V�- A�'A T i (i Iowa Criminal History Record Check Results (DC)trre only) As of /a /—/3 ,a search of the provided name and date of birth revealed: • 0 No Iowa Criminal History Record found with DCI // • Jew -- / Towa Criminal history Record attached,n (� DCI# CR/50--DOI initials �L t' Received T AeySmdl1013 1 : 09PM No, 9343 , Oct. 1. 2013 4: 23PM Div of Criminal Investigation No. 7768 P. 15 IOWA CRIMINAL HISTORY DCI 00209152 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED- 2013/10/01 DCI;00209152 NAME: TOOMER,DAVID ALAN DOB SEX RAC HGT WOT EYE HAIR SRN POB • 19560921 M W 511 200 BRO BRO MED IA ADDITIONAL IDENTIFIERS SC CHIN SC R KNEE • CCH RECORD *** 01 ARRESTED 19700203 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRK#: L10173201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 OPERATE MOTOR VEHICLE UNDER INFLUENCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173201 SENTENCE DISP EFF DAT JAIL 10D 19791120 02 ARRESTED 19860716 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE 1A123-46 PUBLIC INTOX TRK#: 1.10173401 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 TA STATUTE IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173401 SENTENCE DISP EFF DAT JAIL 2D 19860717 03 ARRESTED 19901103 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L10173501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER PER WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173501 Oct. 1. 2013 4: 23PM Div of Criminal Investigation No. 7768. P. 16 DCI 00209152 PAGE 2 OF 3 • SENTENCE DISE' EFF DAT JAIL 2D 19910214 FINE $500 19910214 CREDIT W/TIME SERVED 14H 19910214 04 ARRESTED 19901103 A AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-263 LEAVE SCENE OF ACCIDENT TRK#: L10173601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-261 LEAVE THE SCENE OF PERSONAL INJURY ACCIDENT CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: L10173601 SENTENCE DISP EFF DAT JAIL 100 19920214 CREDIT W/TIME SERVED 14H 19920214 05 ARRESTED 19921001 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI/2ND OFFENSE TRK#: L10173701 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 OWI/2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173701 SENTENCE DISE' EFF DAT JAIL 30D 19930129 FINE $750 19930129 06 ARRESTED 19931126 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED TRR#: 006588001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006588001 , Ocl, 1. 2013 4:23PM Div of Criminal Investigation No, 7768 P. 17 DCI 00209152 PAGE 3 OF 3 SENTENCE DISP EFF DAT JAIL 2D 19940304 FINE $250 19940304 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 DCI. IN THE ABSENCE OF FINGERPRINTS 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