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Home My WebLink About13-219 • r Authorization Number 1. - , .L � _ 1 (Office Use Only) RIS®el, 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 rst 4410. • Larberiet/ 1. Name p. 2. Mailing Addres . •. I .. ! / - /// 3. Telephone: Home ` i —Ot i — her: ' ' `2, A 4. Prior experience in transportation of passengers: g 1e / . efk P ra . ' 9M" * 8 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or el a ,_ 1 T ►e o.o ense ere 4--Win i7►7:.- i, ' .i..•:1 .0/9 , it JV _ ..W . i I�'� • ak r + .1t/ 01 - '111 (nein f-- 6. Have youJle%h convicted of operating .. motor vehicle while under the influence of alcohol or drugs in the last five years? / Type of Offense Where When 7. Have you been convif ted of any traffic offenses in t.e last five years? yeel---- T •-.? '. - Mer here hen 1 r l • �` - t of/ 'i ii ' , _tel_ Lia , ' n.,a __ . I 4 .rye"' • ;, ,f . I . I■_`�" MIAOW .- 8. �' :r • ° : 's�t se . ffeur 'cense been suspended or revoked in t - ast e y-ar I /iV (- 4V Lige of offense Where When 9. Have ou,ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) �d 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) clerldtaxidrivbadg 03/2013 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 app is ffo ay E-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 ► _ Date _W STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by 61't_kt , `.� f�LDc (o�J . On this 8 ("cc) day of VYEMOY S.MMATS Notary Public in an for the State of I Nova Ow Wagon*Aft,TAWS I a 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). Signat re of Polio hief 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. Signa 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 Ger1Utaxidrivbadgeapp201 D.doc 03/2013 (Se; 11. 2013 1 : 50PM ,Div Criminal VIGIA vi .oInvestigation NNNo.. 5684 ,P. �9/10 %°A\ • 1:4-- l4(•a �y>f�Iln•�, �r 1s • STATE OF IOWA. q .A. W4v 'ii � attain g$•JftfetoryRecord Check tl"121113401I`;' • 7: hAPia.g .4 ,1 1.n�.�. legueotForA!A ' ?cP N �'!�I' , efinhLi,,0 ..4•11110.•: DCIA.cclrontN4ulber: • . . QPepptraaaio) . • To XowabivisrohorCrhrnhailhv62Rgedfon Frew eppyo ora/, crn - 8uppoil C(tera/ions Rama;l'INom' oxn- cLERK‘B o1rITin% gidA 114Ore at • 410 R. LIIlh4()•1tt7lO)T"STREET 1iap Mjic9,rowq 50319 (94 7284066 TOW4, CITY Ma 2 4n (579)12.5-6080 Rex , .khon6r 31q-146-•gplkl • ' Ilasre 379 45k=RG9Z • I am ref:Patina Bann Cringnalialsio Record Cheolk an: • ) , Last Marne(mendlroy) _ Fira WO int0(maadfay) ' Mlddlol_'anu_ raamrtetera) M g A/ , • Pan of'LlrthOfrierton.) entirior(lnul(1 ) Soda gool1'ltyMinhr(noommcndea) / Aare' ' ki ei>iio , L • . 450 ' the I xritaloe1;10i1Oatasfgno4Wal*arfomJnosIIItfeosoUthekegaese i rompJate sMtn1nnillfeforyrc4okx1nnyuot . bero(egsahre,per Cade ofXa'i%Chaptor692,2,Yo'.g arim(nslhfeforyrecordIninrmai(on,a.salThwed lig/4W,always • obtaf'n Watversinha(ura1S-om tha4abJaototther4ahbs' efeP.Reremjirhetaaygivaperm Mon fbr[)tbaLownwpwregadelaIdwttdY0114trownoihnlnaffirstaryluatdrfiaanomiagDmaronotocrenef • rerasVgat(on(DO!),r$ygdnrollL/NorydattfoonoomfagnmfatIImainmlnedfgrlhoDQ(myybo rokgo4 nndfowadaylew. I t p Wfiver,SYgmafta- I`tag .. 1 r A in# , • Iowa Cringing!lWstgk'r'lee oici Chock bstat& . NGVaa any> .4.8 or_9 //—/3 j.asehroh,OflkoptovictadnameOld ciao ofbJrthxevcaled( ' 1.1 L`ToIowa c irolnaxH,isioryIteeoxd finiiadwith I)CI XXoWaCanting Bfatoyitetor4ettsohed,DCZ# 029 • Received Time Sep. 6. 2013 2:58P132y4,618 $LV ' ' Ser.). 11. 2013 1 :50PM Div of Criminal Investigation No. 5684 P. 10/10 IOWA CRIMINAL HISTORY DCI 00299366 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- DCI:00299366 2013/09/11 NAME: MORROW,BRET ALLEN DOB SEX RAC HGT WGT EYE HAIR SRN POE 19640403 M W 602 345 GRN RED MED IA ADDITIONAL IDENTIFIERS SC CHEST COM RECORD Www 01 ARRESTED 19030115 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA708-1 ASSAULT TRK#: L23192601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708-1 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L23192401 SENTENCE DISP EFF DAT JAIL 30D 19830413 COURT COSTS $9 19830413 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF OD/LT. 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 C 111 Iowa Department of Transportation Office of Driver Services (Toil Free)800-532-1121 PO Box 9204,Des Moines,IA 5O306-9204 515-244-9124 FAX.515-239-1837 Certified Abstract of Driving Record Inquiry Date: 9/6/2013 DL/ID It: 075AA1630 (IA) Customer 7F: 3617557 Name: Morrow, Bret Allen Class: A ID Status: None Address: 916 20TH AVENUE PL Audit V: 7165136 DL Status: VAL APT 2 Issue Date: 07/24/2013 CDL Status: VAL City/State: CORALVILLE, IA Expiration 04/03/2015 CDL Cert Excepted Intrastate 522411423 Date: Status: Endorsements: NPT CDL Med None Status: Mailing Address: 916 20TH AVENUE PL Restrictions: Corrective Lenses, Restriction None APT 2 Except Class A Bus Supplement: Date of Birth: 4/3/1964 Mailing City/State: CORALVILLE, IA Sex: M 522411423 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 02/08/2011 03/08/2011 NOl Fall to Yield Right of Way Johnson IA 08/31/2012 12/13/2012 F04 Seat Belt Violation Johnson IA 11/08/2012 12/12/2012 592 Speed (10 mph&under in 35-55 mph zone) Linn IA Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 04/26/2007 368947 :IA 02/08/2011 617539 IA . Name: Morrow, Bret Allen DL/ID: 075AA1630 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: sigerteN E yiA 9/6/2013 s¢? IOWA *i a iii„1.11 ORIYLA.st Office of Driver Services Iowa Department of Transportation Name: Morrow, Bret Allen DL/ID: 075AA1630