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Home My WebLink About13-197 Authorization Number r 1 (Office Use Only) a► imisoadritr 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• Iowa52240-182652240-1826 3I.9135..6.75ugu� �(ZS`l/� (319) 356-5497 FAX First, addle as 0�( Las, IL 1 I e 1. Name ---`C�tr1.� � \ C�1 Y�i�� i( vl f 2. Mailing Address DLP " A ✓u_ 3. Telephone: Home (q30 - C?V31 Other: 4. Prior experience in transportation of passengers: -'`de 2 ✓1 v^ e,:1lc\ .J rw 1/Q-4/- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or els; r. � ((�� t7�^�� t Type of offense JJWhe}re�i ., �vH,n�-� 1t e3w P- [ 06 'J G v. .P LJ �p �e� �O✓\ v Or 1`'rl��C� � �j�T�)�(J �i- f✓P cZ \ ) 7 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 0� 8. Has your driver's licerse 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) 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) clerwtaxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number • ( n6 _-- i. I understand that if I falsely answer any questions in this application, that tt 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 L ' Date STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by:III tp*11 c co . On this "I a-v day of Notary 'u.lic in 11,d for the State of I•' a Er. comMu a MMS W ,. ******************************************************************************************************* 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). 9 /-/J Signat e of Pe( '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. c?— / / Signore of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 81/2" (width) and 5'/z" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update cleri taxidrivbadgeapp2010.doc 03/2013 Sep. 3. 2013, 3: 24PIvl Div of Criminal Investigation No. 5918 P. 1/9 flU .�L f• LV IJ II JUn1Y1 'ii 10 � ICIh , Ity VI JUV! VI ty Ivo. JI Y) I . L • • 1 . • • • 155 .�i }•"'. StrAl E OE'IOWA A f'�a 0i.wei j;�F.; k ?I• wo?,• b ling arr•Niltb Record Cheek , ,.,, C i 1 4 , Re/Inuit Form• •vr\ 11'jl' -pi . DeiAaoountNilmbar1 F • • a . 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Na lows CominfilHistoxyklecora fo]iud WithDCr • YO WA C_(bninalIlia tort'Retord attached,bC1#2 1 = Received Time Aug. 27. 2013 11 :57AM No. 3930 Sep. 3. 2013 3: 24PM Div of Criminal Investigation No. 5918 P. 2/9 IOWA CRIMINAL HISTORY DCI 00296487 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/09/03 DCI:00296487 NAME: MICHBL,JANELL CHRISTINE PLOOF,JANELL CHRISTINE PLOOF-MICHEL,JANELL CHRISTINE DOB SEX RAC HGT WGT EYE HAIR SKN POP 19640613 F W 506 155 BLU BIN XA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y SC R KNEE TAT BACK CCH RECORD *** 01 ARRESTED 20040305 AGENCY: • : :100 CORALVILLE PD CHARGE NO- 01 IA STATUTE XA124.401(5) POSSESSION / CONTROLLED SUBSTANCE/SCHEDULE I TRIO: 101106001 COURT DISPOSITION • • AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.414 POSSESSION OF DRUG PARAPHERNALIA COURT CASE ID: 06521 SRCR068000 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101106001 SENTENCE DISP EFF DAT FINE $30 20040709 02 ARRESTED 2012Q414 AGENCY: I• : :500 NORTH LIBERTY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: 1B0004X01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCR097819 CHARGE CLASS: NON CONVICTION TRK#: 1B0004X01 SUBSTANCE ABUSE EVALUATION SENTENCE DXSP EFF DAT DEFERRED JUDGEMENT $315 CIVIL PENALTY 20120727 PROBATION 1Y 20120727 UNSUPERVISED PROBATION, INFORMAL PROBATION REVIEW 02/01/13 DISCHARGED PROM 20130510 DEFERRED JUDGEMENT Sep. 3. 2013 3: 24PM Div of Criminal Investigation No, 5918 P. 3/9 DCI 00296487 e PAGE 2 OF 2 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 EY 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. n f DIVISION OF CRIMINAL INVESTIGATION _I -'V ' ARTS Page I ojl filo Iowa Department of Transportation Office of Driver (Toil Free)800-532-1121 PC Box 9204,Des Moines,IA 50305-9204 515-244-9124 114111. FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/27/2013 DL/ID #: 153BB1954 (IA) Customer#: 1319866 Name: Ploof-Michel,Janell Class: D ID Status: None Christine Address: 406 2ND AVE Audit#: 7282951 DL Status: VAL Issue Date: 08/27/2013 CDL Status: None City/State: CORALVILLE, IA Expiration 06/13/2015 CDL Cert None 522412410 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 406 2ND AVE Restrictions: Corrective Lenses Restriction None Date of Birth: 6/13/1964 Supplement: Mailing City/State: CORALVILLE, IA Sex: F 522412410 '- - — History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 02/04/2009 03/18/2009 '592 (Speed Jackson IIA 1 03/02/2009 03/18/2009 592 Speed (10 mph&under in 35-55 mph zone) Johnson 'IA 04/14/2012 07/27/2012 F04 Seat Belt Violation Johnson IA Name: Ploof-Michel,Janell Christine DL/ID: 153681954 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: OeQF CIF.4'I 8/27/2013 ?¢ IOWA ¢ F 0. 44(1001, Seca p'••• s Office of Driver Services `oB s" Iowa Department of Transportation Name: Ploof-Michel,Janell Christine DL/ID: 153881954 http://172.29.254.55/drivers/reports/customerhistory/certi ieddrivingrecordaspx 8/27/2013