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Home My WebLink About13-233 • Authorization Number I � S 1 1 (Office Use Only) www.�� 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 Cit nw52240-1826 c----(319) 356-5040)Ni 714- (319) 356-5497 FAX rst Middle t 44 1. Name U�jt/"`� .i st3'�� 2. Mailing Address (2-011 b..) 4 S Cc1n >N P3'1, 3. Telephone: Home (5—t23) S` / - Vl/ Other: 4. Prior experience in transportation of passengers: • 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 0W - some' {- c 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? f�> 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. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? c rel Type of offense Where When /Ltr-N c;tr c�t +`i dst {2p0r- _'•-<' j a l S z 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) 71/0 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) clerk/taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number , 4-1;?5?-Xy-(s"7 as. . 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 - Date JO _ 11: I 3 • STATE OF IOWA ) . COUNTY OF JOHNSON ) bs ribed and sworn to before me by �Dke "� kQ r ke.r'- . On this 1+1-4\-- day of 20I9_, .'.A�s KELLIE K.TUTTLE r� e te( r � (� ,i• CLIMMIccinn IVumhnr901A ] tary Public in and for the State of Iowa My Co is,�i Aires IOWA . ********************,******************************** **. ..******************************************************************************* 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). / ! /p / �` !./J Sig ure of Po a '`hief 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. Atu,04-v im /r . �' .� -<f_ / Sign re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/2"(width)and 5'/2" (height)and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update • derwtaxidrivbadgeapp20l odoc 03/2013 • ARTS Page 1 of 2 Wit; Iowa Department of Transportation if ,.; r Office of Driver Services (Toll Free)8[M1-532-t42"! PO Box 9204,Des Moines,IA 50308-9204 515-244-9124 FAX:515-239-1E37 • Certified Abstract of Driving Record Inquiry Date: 9/20/2013 DL/ID#: 428XX4572 (IA) Customer#: 4710398 Name: Parker, Robert Wayne Class: C ID Status: EXP Address: 1204 WISCONSIN ST Audit#: 6470770 DL Status: VAL Issue Date: 11/14/2012 CDL Status: None �I City/State: MUSCATINE, IA Expiration 11/01/2017 CDL Cert None 527611744 Date: Status: Endorsements: NONE CDL Med None Status: I Mailing Address: 1204 WISCONSIN ST Restrictions: Corrective Lenses Restriction None Date of Birth: 11/1/1970 Supplement: Mailing City/State: MUSCATINE, IA Sex: M 527611744 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR .._._ ..... _ _._._ ._ .. . _.. 09/01/2001 _11/27/2001 ;A20 CDeferred Judgment OWI Mu Muscatine {IA 12/16/2004 01/14/2005 595 Drag Racing Muscatine IA 09/22/2005 111/02/2005 820 Driving While Suspended, Denied,Cancelled, Revoked :Linn IA - Sanctions Type Effective End ACD Explanation Occurrence JUR JUR • RevokedA3/08/2005 09/04/2005 S95 Drag Racing _ , ,. _ _ IA IA i Suspended D1/03/2006 ,07/01/2006D27 Violation of Probation IA IA Suspended `05/31/2006 ;07/04/2006 -D51 .Non-Payment of Child Support I IA Suspended 110/11/2006 `06/17/2007 1D51 Non Payment of Child Support IA . Suspended 110/25/2007 104/23/2009 D51 Noy Payment of Child Support IA 7A 110/20/201.1 051 Suspended ,09/09/2009 ,Non-Payment of Child Support IA ;IA Suspended 101/07/2010 102/08/2011 051 .Non-Payment of Child Support IA IA . Suspended jO6/24/2011 110/20/2011 .D51 ;Non-Payment of Child Support ;IA IA I Name: Parker, Robert Wayne DL/ID:428XX4572 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: ..NN\i _'itHICIE c,re. httn://172.29.254.55/drivers/reports/custom erhis tory/certifieddrivingrecord.aspx 9/20/2013 Oct.5 � 1i. . X2013 , 4: 23PM Idii It. 171u1 of CriminalitrInvestiVI gation 111o. 7768 vity P P. 10 • • STATE OF IOWA Alr 1. Criminal History Record Check =r' :•�` Request Form • " ettpm DCIAccountNuinben 4-%c -r (If applicable) To: Iowa Division of Criminal investigation Frome CITY Or IOWA CITY Support Operations Bureau,e Floor ' . CITY CLERXCIS OFFIOE • 215 r,7'h Street 410E WASHINGTON STREET Des Moines,Iowa 50319 (515)725-6066 • _ a (515)125-6080 rag Phone 3191-3565041 Fax; 319-356-5497 I am requesting an Iowa Criminal History Record Check on: . Last Name (mandeloty) First Name(mandatory) Middle Name(recommended) ria r ke r 2 kr tJ a y Date of Birth (mandatoty) . . Gender(�man"dato,)') Social Security Number(recommended) 1 k- 1 U 1�Jiviale ❑Female 1/ 8-9/ 76 4/39- 6 Waiver Information:Without a signed waiver from the subject or the request,n complete criminal history record may not be releasable,par Code of Iowa,Chapter 692,2.For complete criminal history record information,as allowed by law,always obtain a waiver signature from the subject of the request. WaiverReleas'a I hereby nivo parminlon Ibr rho above requesting official to conduct an Iowa crfInfrml hl4lory record checkuldi the Dlvillon of Caminel (nvesligallon(DP. Any criminal hlsrory data eoncemin hot Is malum by tiro DCXm +scd as allowed by law. • Waiver Signature: C Ioa Criminal History Record Check Results (DCI use only) As of l0— / 1.3 ,a search of the provided name and date of birth revealed: . : ❑ No Iowa Criminal History Record found with DCI • IX Iowa Criminal History Record attached,DCI# 5/3995 • • DCI initials f Received Time'7Seti. 27. 02013 12: 18PM No. 9341 Oct. 1. 2013 4: 23PM Div of Criminal Investigation No. 7768 P. 11 IOWA CRIMINAL HISTORY DCI 00513995 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 • DATE PRINTED- 2013/10/01 DCI:00513995 NAME: PARKER,BOB PARKER,ROBERT WAYNE DOE SEX RAC MGT NOT EYE HAIR SKN POE 19701101 M W 600 304 GRN ELN FAR IA ADDITIONAL IDENTIFIERS SC HEAD SC L KNEE TAT L ANKL TAT L CALF TAT L HND TAT L SHLD TAT R CALF TAT R SHLD CCH RECORD *** 01 ARRESTED 19951121 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA706-2A-2A DOMESTIC ASSAULT TRK#: 016773701 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 DOMESTIC ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 016773701 SENTENCE DISP EFF DAT PLEAD GUILTY ATTEND BATTERER'S PROGRAM 19960209 JAIL 2D 19960209 PROBATION 1Y 19960209 SUSPENDED 28D 19960209 02 ARRESTED 19980523 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA719-1 INTERFERENCE WITH OFFICIAL ACTS TRK#: 040584301 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA719-1 INTERF W/OFF ACTS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 040584301 SENTENCE DISP EFF DAT PLEAD GUILTY 19980604 FINE $250 19980804 PROBATION 18M 19980804 Oct. 1. 2013 4: 23PM Div of Criminal Investigation No. 7768 P. 12 DCI 00513995 PAGE 2 OF 3 SUSPENDED 30D 19980804 03 ARRESTED 20010127 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA708-2-2 ASSAULT TRK##: 025149001 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#}: 025149001 SENTENCE DISP EFF DAT PLEAD GUILTY 20010504 FINE $75 20010504 04 ARRESTED 20010901 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA321J-1-2-A OWI 1ST OFFENSE TRIO: 028410201 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 (A) OPER VEH WH INT (OWI) / SER MISD / 1ST OFF - COURT CASE ID: 07701 OWCR022371 CHARGE CLASS: NON CONVICTION TRK#): 028410201 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20011127 PROBATION 18W 20011127 COMMUNITY SERVICE 40H 20011127 DISCHARGED FROM 20030926 DEFERRED JUDGEMENT 05 ARRESTED 20050511 AGENCY: 1A0700000 MUSCATINE CO SO CHARGE NO- 01 IA STATUTE TA708.A-2A DOMESTIC ABUSE 1ST OFFENSE TRK#: M00488701 COURT DISPOSITION AGENCY: /A070015J MUSCATINE CO DIST COURT Oct. 1. 2013 4:23PM Div of Criminal Investigation No. 7768 P. 13 DCI 00513995 PAGE 3 OF 3 COUNT NO- 01 IA STATUTE IA706.2A(2) (A) DOMESTIC ABUSE ASSAULT COURT CASE ID: 07701 SMCR031663 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: MO0400701 SENTENCE DISP EFF DAT TIME SERVED 2D 20050701 JAIL 2D 20050701 AM ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION XS A PUBLIC RECORD BUT CAN ONLY HE 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