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Home My WebLink About13-222 r Authorization Number 1 7j - -oZc>1.. 1 (Office Use Only) 4ne011,0i-tiksharts iges ow ZIT 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 ,,\\ .rst ,�1 Ie Last 1. Name Mitt .N k rDeir) P 2. Mailing Address 1 Q se C ti v riA c5j reef; it,oa 0,/ , 1 A ,2. z q5 3. Telephone: Home r9:.) 631 - 41113 Other: 4. Prior experience in transportation of passengers: Ola Ca i; l,d. cSkac-L) Nbd• 5+ Zfxl 2 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? /43 Type of offense Where When ApoNev,Av•ifitnyasq. InwaC;4y Ill( 71`fq - o�P�S:oy lew2 (;ty ll 30/ i yq? 6. Have you ben convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When A)0 7. Have you been convicted of any traffic offenses in the last five years? Np Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? JVc 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) Inv( 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) clerktlaxidrivbadg 03x'2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number' (16 eA A Vg 2. 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 Date / 4/20(3 ll STATE OF IOWA COUNTY OF JOHNSON ) S bscribed and sworn to before me by 1)1i , ; ]) - 4 mef�z" 6-:ix-. On this ` day of �G2 C2'L�l L / Notary Public in and for the State of 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). "25 ' /3 S nature 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. - 9/d-51/3 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 5 '/2" (height)and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp2010.doc 03/2013 Iowa Department of Transportation + .,�.. Office of Driver Services (Toll Free)800-532-1121fis.ra- Box 9204,Des Moines,IA 50306-9204 515-244-9124 Ille FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 9/25/2013 DL/ID#: 960AA8821 (IA) Customer#: 1832136 Name: Mcfadden, Matthew Duff Class: D ID Status: EXP Address: 2217 MUSCATINE AVE APT 7 Audit#: 6421678 DL Status: VAL Issue Date: 10/26/2012 CDL Status: None City/State: IOWA CITY,IA 522406634 Expiration Date: 02/14/2014 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 2217 MUSCATINE AVE APT 7 Restrictions: NONE Restriction None Date of Birth: 2/14/1977 Supplement: Mailing City/State: IOWA CITY,IA 522406634 Sex: M History Information CLEAR DRIVING RECORD Name: Mcfadden, Matthew Duff DL/ID: 960AA8821 Pursuant to Iowa Code §321.10, I, Klm 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; "\WCIEk1k, 4. W.p4t 9/25/2013 •Piti IOWA %.0% °lin" 0 n�.;D. O. tie/ I,II'C�e '�\/l. IowaOffice of Driver rtmr DepartmentServices of Name: Mcfadden, Matthew Duff DL/ID: 960AA8821 Sep. 23. 2013 2:45PM Div of Criminal Investigation No. 8718 P. 4/9 M - 1r9/19/2013 10:24 FA• X y DCI IOIYA 1.0004 STATE OF IOWA . Criminal History Record Check 11112 ' Request Form • DCI Account Numbor: r)"Pc" M (it rppik bk) � To: Iowa Division of Criminal laveetlgattoo From: t ik(L'aS l R)t 1 Support Operatioaa Burma,l"Floor 215 6,711 Street te $A'sAlto6 fir. Moines,aorta tW3t9 (515)725.44%6 000, , A 5 39 o (Sly 7ZSOL b6 (515)725.6080 Fax Phone: ,(316t) 338 Fax: . (3[9) 5511,-94 I tin T.ruestin; an Iowa Criminal Hist, Record Check Last Name(rte++ 7) _ Firer Name( +tory) Middle Name�reoemmcodaa) "l rcl d e ■ Date of Birth t�,a.wry Gender(n, Z_ Social Security Number tr of (-14/NA /I(� /) t - MMle ❑Female s5- Waiver�Infformatiion:: Without a signed waiver from ibe eobJect of the request,a complete criminal history record may not be releasable,per Code of lows,Chapter 642.2.For=ads crtmiaal bbtory record tabrmadon,as allowed by law,always . obtain a waiver stare hen the sub act of the •.ueet. Weaver Release:I hereby give penntsrion for thy atom rvqua,*1t efY et to conduct o Iowrt criminal history word check with hie Dtvtrloo of Cr m r J Invelltg/ri (DC1). Any mania!history data memo,' or that Is; do DC1 ' reirsed Y slowed by low Waiver Signature: ylre i� A A —_ - Iowa Criminal History Record Check Result& (ochre only) As of q 3-/3 ,a search of the provided name and date of birth revealed: 0 No Iowa Criminal History Record found with DCI Iowa Criminal History Record attached,DC10_ 5P Li 9 7 DCI DCI-77(46x19110) - Received TIrP. Sen. 19. 7011 I0: 77AM No. 6A9 Sep. 23. 2013 2:45PM Div of Criminal Investigation No. 8718 P. 5/9 r . N IOWA CRIMINAL HISTORY DCI 00564967 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/09/23 DCI:00564967 NAME: D'LORISTO,SHADOW DLORISTO,SHADOW MCPADDEN,MATTHEW DUFF SHADOW,D'LORISTO SHADOW,DLORISTO DOB SEX RAC HGT HOT EYE HAIR BEN POB 19770214 M W 601 175 HAZ BRO FAR CA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19971114 AGENCY: IA0520400 IOWA CITY MTV SEC PD CHARGE NO- 01 IA STATUTE IA713-5-2 BURGLARY 2ND DEGREE TRK$$: 018686601 • COURT DISPOSITION AGENCY: IAO52015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE XA716-7 TRESPASSINO CHARGE CLASS; MISDEMEANOR CONVICTION TRK4I: 018686601 SENTENCE DISP EFF DAT JAIL 26D 19971219 COURT COSTS 19971219 02 ARRESTED 19991130 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSE SCR I - MARIJUANA TM: 047944901 COURT DISPOSITION AGENCY: IA05201SJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE - SR CHARGE CLASS: MISDEMEANOR CONVICTION TRU: 047944901 SENTENCE DISP EFF DAT JAIL 48H 20000530 FINE $250 20000530 COURT COSTS LIC REVKD 20000530 03 ARRESTED 20000627 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE SA708-2-3 ASSAULT WHILE DISPLAYING DANGEROUS WEAPON TRKH: 053311601 COURT DISPOSITION Sep. 23. 2013 2:45PM Div of Criminal Investigation No. 8718 P. 6/9 DCI 00564967 PAGE 2 OF 2 AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708.1(1) INTENT TO CAUSE PAIN OR INJURY COURT CASE ID: 06521 SMSM035548 CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 053311601 SENTENCE DISP EFF DAT FINE $125 20001107 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. TRIS 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. • F DIVISION OF CRIMINAL INVESTIGATION ),w'p'( )