Loading...
HomeMy WebLinkAbout13-189 Authorization Number / 3 �'X9 r . (Office Use Only) tom` Aka °an�11 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 First 0 A MiddleLast 1. Name // odA e, pearl ,� Gt r 2. Mailing Address G '- f(7)‘ Tr4 I I 3. Telephone: Home 30-- 337-?Zv- Other: 3/ FS.S a 160 4. Prior experience in transportation of passengers: ..F Ulf Get Id e/t -Pt, )/c/(D c,t) �=R� 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? C re-c6a1 1-0 e6 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? Jv C' Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? X e5 — /4 a ch') Type of offense Where When Spca1f(cna1c 1(4 /T012_v Sive , T-o /2 hi* 2 01( 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Alb 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) P© 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 9&O r'] Y0 -2 . 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) 3 asei-i-Signature of Applicant I/1, ( `�OthDate 2_0' STATE OF IOWA COUNTY OF JOHNSON ) Sbscribed an,d sworn to fore me by 10 1 Q 1 ►' . On this .0 . day of 2-().1 7 TUTTLE // Qac pCE�IIE Number 221819 ( � /� s Expires 0 9 c°miss10�;ssto I k otary Public in and for the State of Iowa l°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). Signa re of P li e 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 tt icgov.org. 5 g - Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 51/2" (height)and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp201 o.doc 03/2013 mug. 19. Lir ii II :7nhIYl Li1V 0 I.r imi na I Investigation no. [y7[ r. vo 160Z '°N iVdll 4 £101 'EI '54 ami1 pediamil • `; STATE OF IOWA . .00 1, • er. Criminal History Record Check Request Form 5 77r • • DCI AccountNuniber: • 9967-F Of applicable) To: Iowa Division of Criminal Inyestloatlon From: Yellow Cab of ten City Support Operations Bureau,l's Floor • P.O.Box 428 315 E.7'h Street • Des Moincs,Iowa 50319 • Iowa City,IA. 52244 (515)725-6066 • • (515)725-6080 Fax (319)335-9777 Phone: • Fax (319)339-7302 • I ern requesting an Iowa Criminal Histoty_Record Check on: Last Name(mandatory) Pint Name(mnnuoroy)'. Middle Name(recommended) ' la r �v 4.0 y Dei Date of Birth(monaro,y) p Gender(mandmoty) 'Social Security Number(recommended) • a3fb5/l�'6 ,MMaie °Female q3/- 70. -753.2 Waiver Information: Without a signed waiver from the subject of therequest,a complete criminal history record may.not be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history record Information,as allowed by iaw,.alwoys ' -obtain a waiver signature from the subject of the request. • • - • Waiver Release:I hereby elm pmmirsion for she above Reuniting official mroondoct an lows cibninel history;ewd elm*with the Division of Criminal • rnvesligeiion(XI). My Mahal hmory dais concerning me this b abnelned by Me DCI may be released at allowed by law.' Waiver Signature: /�zakiiSail Al • • Iowa Criminal History Record Check Results (DCI only) • As of 6-1q-- ( 3 a search of the provided name and date of birth revealed: No Iowa Criminal History Record found with DCI• • • Iowa Criminal History Record attached,DCI# 3/6,q55 DCI initials c) . DCI.77(08/25/10) • • Aug. 19. 2013 11 :56AM Div of Criminal Investigation No. 1991 r. LID IONA CRIMINAL HISTORY DCI 00316955 FELONY'CONVICTION PAGE 1 OF 5 PATE PRINTED- 2013/08/19 DCI:00316955 NAME: BLAIR,ROD BLAIR,RODNBY DEAN POE SEX RAC HOT WGT EYE HAIR SKN POE 19660305 M W 601 278 HA2 BRO MED IA ADDITIONAL IDENTIFIERS SC R WRIST SC UL ARM CCH RECORD •** 01 ARRESTED 19840401 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA715-1-6 FLS USE FIN INSTR IND TRKO: L25003001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA715-1-6 ELS USE FIN INSTR 2ND CHARGE CLASS: STATUS UNKNOWN TRKtf: 1,25803001 SENTENCE DISP EFF DAT JAIL 110 19840412 02 ARRESTED 19840530 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT IND TRIO: L25803101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 OPERATE MOTOR VEHICLE W/OUT OWNER CONSENT ' CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: L25803101 SENTENCE DISP EFF DAT PLEAD GUILTY 19840822 JAIL 72D 19840822 03 ARRESTED 19850625 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-5 THEFT 5TH DEG TRIO: L25803201 COURT DISPOSITION AGENCY: IA052015.1 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-5 THEFT 5TH DEG Aug. 19. 2013 11 :57AM Div of Criminal Investigation No. 2952 N. 3/6 • DCI 00316955 PAGE 2 OF 5 CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: L25803201 SENTENCE DISP EFF DAT PLEAD GUILTY 19850708 PINE $100 19650708 04 ARRESTED 19650725 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 TA STATUTE IA713-5 • BURG 2ND DE0 TRK#: L25803301 COURT DISPOSITION AGENCY. IA052015J JOHNSON CO DIST COURT COUNT NO- 01 • THEFT 4TH CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25903301 RESTITUTION • SENTENCE DISP EFF DAT PROBATION 1Y 19851002 SUSPENDED 90D 19851002 05 ARRESTED 19860320 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT 2ND DEG TRK#: L25803401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-2 THEFT 2ND CHARGE CLASS: FELONY CONVICTION TRK#: L25803401 SENTENCE DISP EFF DAT PROBATION 5Y 19870129 CREDIT 22D • 06 ARRESTED 19860610 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-1-3 THEFT 2ND DEG TRKN: L25903501 COURT DISF081TION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-1-3 THEFT 2ND DEG Aug. 19. 2013 11:57AM Div of Criminal Investigation No. 1952 Y. 4/b • DCI 00316955 PAGE 3 OF 5 CHARGE CLASS: FELONY CONVICTION TRIO: L25803501 RESTITUTION SENTENCE DISP EFF DAT PROBATION 5Y 19B70129 07 ARRESTED 19870107 AGENCY,: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA700-4 WILLFUL INJURY TRK$: L25803601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 TERRORISM CHARGE CLASS: FELONY CONVICTION TRK#: L25603601 RESTITUTION SENTENCE DISP EFF DAT CONCURRENT W/CYCLE DOA 06/10/86 19870226 PRORATION SY 19870226 00 RECEIVED 19870129 AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA714-2-2 THBPT 2ND TRK$: L25803701 INMATE #: 003150 CHARGE NO- 02 IA STATUTE IA714-2-4 THEFT 4TH TRK$: L25003702 COURT'DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-2 THEFT 2ND CHARGE CLASS: FELONY CONVICTION • TRK#: L25803701 SENTENCE DISP EFF DAT PROBATION 5Y 19870129 COURT DISPOSITION AGENCY: IA0520150. JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA714-2-4 THEFT 4TH CHARGE CLASS: MISDEMEANOR CONVICTION TRK#. L25803702 SENTENCE DISP EFF DAT Aug. 19. 2013 11 :57AM Div of Criminal Investigation No. 2952 V. h/b • DCI 00316955 PAGE 4 OF 5 CONSECUTIVE SENTENCE WITH CT 01 19870129 JAIL 90D - 19870129 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 03 TERRORISM CHARGE CLASS; FELONY CONVICTION TRX# D25803703 SENTENCE DISP EFF DAT JAIL 5Y 19870226 CONCURRENT WITH CT 01 & 02 19870226 CUSTODY AGENCY: IA051015C ANAMOSA MENS REFTY A 19870226 RELEASED BY COURT ORDER CUSTODY AGENCY: IA053015C ANAMOSA MENS REFTY B 19870226 RECEIVED REED ON COURT ORDER CUSTODY AGENCY: IA077015G ADULT PAROLE SVC C 19880302 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC D 19881208 PAROLE REVOKED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC E 19890510 PAROLED CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC P 19890831 DISCHARGED FROM CRIMINAL JUSTICE SYSTEM 09 ARRESTED 19881116 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA906-1 PAROLE VIOLATION TRK#: L25803801 COURT DISPOSITION AGENCY: IA05201SJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA906-1 PAROLE VIOLATION CHARGE CLASS: FELONY CONVICTION TRK#: T25803801 SENTENCE DSSP EFF DAT TO SERVE SAL 06/10/86 19900703 10 ARRESTED 19901102 AGENCY: Aug. 19. 2013 11:57AM Div of Criminal Investigation No. 2952 V. b/b DCI 00316955 PAGE 5 OF 5 IA0520200 IOWA CITY PD CHARGE NO= 01 IA STATUTE IA714-1-6 THEFT ,IST TRK#: L25803901 COURT DISPOSITION AGENCY: IA0520153 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-1 THEFT ).ST CHARGE' CLASS: FELONY CONVICTION TRK9: L25003901 SENTENCE DIE? EFF DAT JAIL 10Y 19910912 2D CREDIT 11 RECEIVED 19910913 • AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA714-2-1 THEFT 1ST TRKR: L25804001 INMATE 8: 003150 COURT DISPOSITION AGENCY: IA052315J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-2-1 THEFT 1ST CHARGE CLASS: FELONY CONVICTION TEM: L25804001 SENTENCE DISP EFF DAT JAIL 10Y 19910913 CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC A 19940714 PAROLED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC 19960714 DISCHARGED FROM CRIMINAL JUSTICE SYSTEM 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 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 • IIowa Department of Transportation Office of Driver Services (Toll Free).806332-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/28/2013 OL/ID#: 960AA9807(IA) Customer#: 2228817 Name: Blair,Rodney Dean Class: B ID Status: None Address: 602 FOX TRL Audit#: 4223732 DL Status: VAL Issue Date: 03/30/2010 CDL Status: VAL City/State: IOWA CITY,IA 522409209 Expiration 03/05/2015 CDL Cert Status: None Date: Endorsements: L CDL Med Status: None Mailing Address: 602 FOX TRL Restrictions: NONE Restriction None Date of Birth: 3/5/1966 Supplement: Mailing City/State: IOWA CITY,IA 522409209 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/01/2009 05/18/2009 .592 Speed(10 mph&under in 35-55 mph zone) 'Washington 'IA 12/08/2010 01/03/2011 Improper Registration ;Johnson IA 11/14/2011 '12/07/2011 592 •Speed Johnson IA 01/08/2012 02/28/2012 S15 :Speed € IL Accidents-Accident involvement indicated does NOT mean the Individual was at fault or given a citation. Accident Date Case Number JUR 08/20/2007 389515 IA 09/07/2007 392736 IA Name:Blair,Rodney Dean DL/ID: 960AA9B07 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: 5 ,VUICIf B,/,4 ,`®:.•• wyt 8/28/2013 4:i IOWA%At, / ?D. O.T. e% a e 4 %,.°4-.. �, %„oA %,- Office of Driver Services wti 1 s Iowa Department of Transportation Name: Blair,Rodney Dean DL/ID:960AA9807