The URL can be used to link to this page

Home My WebLink About13-218 Authorization Number 1.--�lo � — i. (Office Use Only) III `+'1.116_ 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 First Middle Last 3�" .. <l er 1. Name t t, y j Gam, 1'�L4 trr V� 2. Mailing Address 1::), 0 G c 5 ` I ' --4,-in -T,.._., 2- 3 y 0 3. Telephone: Home p _31 1 - cf �. �� Other: 4. Prior experience in transportation of passengers: 10 mt., - 0 a_A)-e. r-A. S @-y 1 tie YLQ� r �/ C j Lk & ( —{— C V', ,,1c G a o'I ✓1 --t,�t ti4 s c) r\c'--rl irk,'' 1 C- 1 tv e rsan -- ',i .)0( K- —(o e P 1 2( Li- IZ tyls4_, 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ✓L 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? nr-y Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? U ff5 Type of offense Where J When 5106-e it—.(.:::_••0 C <- .9,6 L 3 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ()c, 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 b 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) clerkltaxidrivbadg 03/2013 I hereby certithat I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ' , -9("4y J ( . 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 wit 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 wit all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature ofAp.lican �� G lattice. . ..t• • Date 9 / 2op ***** ****** ******************************************.******** STATE OF IOWA COUNTY OF JOHNSON Subscribed and sworn to before me by cav\ \Z\1 «v S\c . On this day of r .�\ Notary Publ in and for the tate of IowaX13 �`t ************************************************************************************************************************************************ 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). Signa�e of P. is• 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. gA-,),ph_3 Signe, re of City Clerk or des:gnoe Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 81/2" (width) and 51/2" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update derk/faxidrivbadgeapp2010.doc 03/2013 ifIowa Department of Transportation Office of Driver Services (Toil Free)600-532-1121 PO Box 9204,Des Manes,IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 9/12/2013 DL/ID#: 432YY0121 (IA) Customer#: 692807 Name: Strickler, Karla Mary Class: C ID Status: None Address: 3701 2ND ST LOT 3 Audit#: 4896123 DL Status: VAL Issue Date: 12/21/2010 CDL Status: None City/State: CORALVILLE, IA Expiration 12/25/2015 CDL Cert None 522413203 Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: PO BOX 518 Restrictions: NONE Restriction None Date of Birth: 12/25/1960 Supplement: Mailing City/State: TIFFIN, IA 523400518 Sex: F History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 02/25/2013 103/13/2013 S92 'Speed llohnson IIA Accidents -Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR _ 07/31/2009 1519815 lIA Name: Strickler, Karla Mary DL/ID: 432YY0121 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: w 4 `e'• .***OR la 9/12/2013 ,, I ' IOWA 40 a c�� `z �fy , 4q If* ***** r Office of Driver Services l`"„� r' Iowa Department of Transportation Name:Strickler, Karla Mary DL/ID: 432YY0121 _SSep, 19. 2013 12: 38PM Div of Criminal Investigation No. 8328 P. 6 b vep. Iv. LVU 2 . IUnin lolly ,ItIK ',IL)? et JUWd blty No. loos F. i am« ? ' CriSTATE OF IOWA \ as. % -' k(mvn•l � nal History Record Check • i.. ,,:. ,..;,: • Val 0-_11/44Request Form • ov • I - ns . - DOI Account Number; L*0 0 . , (itopplleable) To: Iowa Division of Criminal Investigation 1 rom: City of Iowa City Support Operations Bureau,VI Eioor City Clerk's Office 215 L.7th Street 410 T.Washington Street Ilea Moines,Iowa 50319 (515)725-6066 Iowa City, IA 52240 (515)7256080 Flax phone: 319-356-5041 Tax: 319-356-5497 `r o.,.:. I am requesting an XoWa criminal History Record Check on: Last Name Onendetory) First Name(mandatory) Middle Name(reeonmtcndot) r Date of Birth Onaddatory) /�, Gender(mandatory) Sloc/ial Securrit7y�Nu berr (rcccmmcndcd) alAS JLcO DMale )4remale 4R — 7 b a Waiverinfopntalloltr 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,rot complete criminal history record information,as allowed by law,always obtain a waiver signature from the subject of the request. Waiver Release:]hereby give permission for the above rerruesang oftiaal ro conduct en Iowa criminal history record check will)the Divramn of Criminal Investigation(DCI). Any criminal history dataconcenrin me lb a maintained by the DCI may released es allowed aw. Waiver Signature: /2-4,-4,- tr ....V : IC Iowa riminal History Record Check Results MCC=only) .I As of (ACM 13 , a search of the provided name and date of birth revealed: • No Iowa Criminal History Record found with DCI • 8 Iowa Criminal History Record attached,DCI# . DCI initials Received Timel;S`p,,14;.4013 9: 16AM No. 7670