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Home My WebLink About13-187 Authorization Number � - ' Z7 1 (Office Use Only) -IreiZia cm; .wr®la 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 1. Name p- //]]/� Yra�9' 2. Mailing Address /�� Cr�'i'�'�cw e7" ; N4' h 4dcrf y 53/7 3. Telephone: Home I/ 9 936 /I G / Other: 4. Prior experience in transportation of passengers: N kr / Taf►, 0/4 Cap,tv / iPdcife7451— 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? fl 0 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? /)0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? yes Type of offense Where When fo-,l u ee l 0 y tt!G/d Rr 9 0.0 f>,„o-y Cv rod v,//c. ,t,9' 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? j7o 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) n0 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) derk/taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ' 56 3 /9'6- 3 V7 b . 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 / Date6/.2/// 3 STATE OF IOWA ) COUNTY OF JOHNSON ) 1 Sui'scribed an. sworn to before me by S-1.--f rI i �,'1--(--a . On this day of ie (0.A! KELLIE K.TUTTLE � � / - ' ` u o s7 commission mber 221819 Notary Public in and for the State of Iowa My c. mi, •n •.b low. /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). ignaturof 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. 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 5'/2" (height) and prominently displayed to all passengers. *********************************************************** ,,,,*** ,,,„***************************************.****************************** Office Use Only Approved application DCI report State certified driving record Website update clerkltaxidrivbadgeapp201odoc 03/2013 Aug. 27. 2013 3: 36PM, Div of Criminal Investigation No. 5318 P. 1/2 • ta LUIi 3,i.3,65 ul eI y �iern of ry vu e, IOWL blly no. 3/01 r, J/] • • '{,r :•c STATE Or XOWA 1,9;4;,:;.;";� , . i` i Yy IOWA,- 71 al. istory Record Cheek ' , ;t ,,t::�?!,.,*,. �rimin ( .t s. 3'A T T' ,,1 { % nl i' :if a'•"`�"°u•/ q %� Request Form, ft's;� a X1°`1' _ a ;p , - DCIAccouatATumbor "(-oec- -• r • - Qtnpplrcolo) To; Iowa Dfvfafou of Criminal7hvestigatton Atom% CITY or TONCITY Support Operating Durenu,lelPoor ern =WO o$TIc) 215E.7'hStrent • 410 E. 1197010}1 SMELT b al tolnos,IOWA 50019 - 015)725.6066 IOWA CITY xold'A . .52240 (515)72S-6080 Parc • phonal 119.356--5041 Atm 919-95k,5447 • I am requesting an Town Criminal Iilslon'Record Cheek on: Last Name(mendalory) . FitsstN'ame(mandatory) ' Middle Nara e(recommended) / pie/ /n/ /"py,r, Y Ohers • J7atooin3iilh(,rlrndalory) Qo11110r(mnndaory) Social Seculitc Number(reoomlcndea) CW/o /i9 a [Male Orem- ale 333 - y J s O/ V 9 Waiver information:Without a signed waver from the subject of the request,a template criminal history record may not be 1'emordfea per Code Wawa,Chapter 692,2,IYor cotnplete•criminnlhistory record informatfotr,as al&owod by)ayv,always • obtafh A 1vaiVer signature font 0104.11b4Oct of the requast; ) itiVe l?eIegS&:Yhcrcbygivepermb,(onlbrlhonbovaregaeslingoltloieltoronduoialYow*criminalhisloymardcheekwill{haDNfalanactiminol Tnvanlganon(DOD. Any orlmhrel Merin darn don :ofnuhlo lhatls mthrn:nod by rhDDol moy bo relemel o r Mowed by inw. W M'cr Signature; • S ta6chic.e F Iowa Criminal History Record Check Results , - roc)arc only) As of . 951 a� I I , a search of tho.provlded name and date of blrthsevealed: • • No Ibwa Criminal HistoryRecord found wlthbCT . • ❑ Iowa Criminal History Record attached) b CT it • bCt initials • DC1,71(08/25/10) . Received Time Aug. 20. 2013 1 : 12PM 'No. 3167 . • Iowa Department of Transportation ..¢s Office of Driver Services (Toil Free)80O-532-1121 PO Box 9204,Des Moines,IA 5030&9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/20/2013 DL/ID #: 563AG3876(IA) Customer#: 5899630 Name: Strang, Sterling Class: D ID Status: None Douglas Address: 320 2ND ST APT 229 Audit#: 6438599 DL Status: VAL Issue Date: 11/02/2012 CDL Status: None City/State: CORALVILLE, IA Expiration 02/16/2016 CDL Cert Non-Excepted 522412649 Date: Status: Intrastate Endorsements: 3 CDL Med None Status: Mailing Address: 320 2ND ST APT 229 Restrictions: NONE Restriction None Date of Birth: 2/16/1982 Supplement: Mailing City/State: CORALVILLE,IA Sex: M 522412649 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 12/29/2012 ;01/29/2013 . NOl Fall to Yield Right of Way Johnson ,IA 03/28/2013 04/08/2013 ,592 Speed Johnson IA ,• Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 12/29/2012 719193 IA Name: Strang,Sterling Douglas DL/ID: 563AG3876 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: oQ•'''''lf'. is 8/20/2013 '47 IOWA .2h ai:D. O. T. 1; I k DUO SJR/' IowiceDepartmemervic Transportation