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Home My WebLink About13-170 Authorization Number ) C.' 1 � 1 (Office Use Only) 441, .9.i ow 43117 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 , X319) 356-504IC-`,I (319) 356-5497 FAX � FirstMiddle Last 1. Name 6'.:4 it;4 JS q Y in/u 2. Mailing Address 37D/ 2ne." s7 Lti ,774 CG`j,(','//c 1 q 'V/ 3. Telephone: Home 21'7-7,y3-0,5 2 Other: 4. Prior experience in transportation of passengers: /(5 /0 U i iV cr5(1/ ) &f nJ f v/ 1,7 e'4,:j. 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? e c S 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? ./Vci Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 4.c' Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? -'!/v 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) 4r 0 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTJFIED 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) clerkttaxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 7 -,11-4 1 C' . 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 (,r�,i" Date J `l -/2 STATE STATE OF IOWA COUNTY OF JOHNSON ) S bsribed and s Norn to before me by r--e I GOGt- l—�_ i . On this ) day of ;qi KELLIE K.TUTT C (f`e K / c`H—4 ' y.z Commission Nu221819 Myr� sslomber Epi es Notary Public in and for the State of Iowa ***********#****************************************************************************#*************************************************#***** 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). -2//3 Signature of 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. 7,2 -i3 Sig ture 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 1/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp2010 doe 03/2013 a Pty Sla .1RAgo5a • 4 IOWA r A ' COMMERCIAL.DRIVER LIC •SE ., a WALNITER DAEL RAY ti //z t 3701 2ND ST LOT 379'� y ., ';CORALVILLE,IA 52241 I ••. } M.No.075AA1980 I ens 155 12/1712011 OCR 02.11_5120•0 p CiassB End NONE a y sHoteix 3" .tea Restrictions Eyes BLU B j _ !(// D0602485H91� i. GV DO zsssozasnwasism1sozi�ao ' ;Aug. 9. 2013 . 9:09AM-I• 1 . 1Div of Criminal Investigation. '• ' '.. " ••• ,JNo. 2974 ,P. 2/17 •', ; ' ) . , nob" P ,4V I J+1 er4U/IYJ 1 '.oily IC:'A — V1.14:0 I. 101'!2-VItl', ', • .' l' , .!(0.'.,S Ili( i'f . 7( ' '... ''1 •I 1) ., I . .I, ,. 'I , . I il ' 'I:•.1 1.11. .I.r , r, ;, ♦I -' / 1 - . . ' i '..' . ♦ � . '. 'I I ♦ . I .I I • ; ,.I.. : '1' ' ...7. , P . 1 .' -1 • ' .I I, , I . 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Aug. 9. 2013 9: 10AM Div of Criminal Investigation No, 2974 P. 3/17 IOWA CRIMINAL HISTORY DCI 00522389 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE, PRINTED- 2013/08/09 DCI:00522389 NAME: WALTER,DAN WALTER,DANIEL RAY DOB SEX RAC HGT NOT EYE HAIR SRN POB ' 19750215 M W 603 230 GRN BRO FAR IA ADDITIONAL IDENTIFIERS • SC L ELB CCH RECORD ++'* 01 ARRESTED 19960423 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION TREY: 009814901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING W/SUSPENDED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 009814901 SENTENCE DISP EFF DAT FINE $300 19960723 02 ARRESTED 19961221 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2 ASSAULT CAUSING INJURY TRK#: 027182801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708 2A-2-B ' ASSAULT CAUSING INJURY-DOMESTIC ABUSE COURT CASE ID: 06521 SRCR043273 CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 027182501 RESTITUTION SENTENCE DISP EFF DAT SUSPENDED JAIL 56D 19970425 JAIL 60D 19970425 FINE $250 19970425 PROBATION 11 19970425 BATTERER'S EDUCATION 19970425 PROGRAM COURT DISPOSITION AGENCY: IA0520150' JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA665-4 (2) CONTEMPT OF COURT COURT CASE ID: 06521 SRCR043273 Aug. 9. 2013 9: 10AM Div of Criminal Investigation No. 2974 P. 4/17 DCI 00522389 PAGE 2 OF 2 • • CRARGE CLASS: MISDEMEANOR CONVICTION TRK#; 027182602 SENTENCE DISP EFF DAT JAIL 13D 19980416 FAMILY COUNSELING 19980416 PROGRAM COURT DISPOSITION ' AGENCY: IA052015J. JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE IA708-2A REVOCATION OF PROBATION CHARGE CLASS: MISDEMEANOR CONVICTION TRrc1 027182803 SENTENCE DISP EFF DAT JAIL 4D 19990325 COURT COSTS 19990325 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTXFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON-LAW ENFORCEMENT NCIES BY THE DCI. IN THE ABBE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INF RMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION ARTS Page 1 of 1 • Iowa Department of Transportation 43- Oxuce of Driver Services (Coil Free)8005321121 . PO Bux 9204,Des.Moine%to 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/3/2013 DL/ID#: 075AA1980 (IA) Customer#: 551316 Name: Walter, Daniel Ray Class: B ID Status: None Address: 3701 2ND ST LOT 379 Audit#: 5690248 DL Status: VAL Issue Date: 12/17/2011 CDL Status: VAL City/State: CORALVILLE, IA Expiration 02/15/2014 CDL Cert None 522413203 Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: 3701 2ND ST LOT 379 Restrictions: Corrective Lenses Restriction None Date of Birth: 2/15/1975 Supplement: Mailing City/State: CORALVILLE,IA Sex: M 522413203 History Information CLEAR DRIVING RECORD Name: Walter, Daniel Ray DL/ID: 075AA1980 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: .10 •" ''•.y4y 8/3/2013 f/�y tom? I. O. T. :es $C�� '�C:J�� ^ r h';D. O. T. 6r�%0%"' 4_ Office of Driver Services "Ty -" Iowa Department of Transportation Name:Walter, Daniel Ray DL/ID:075AA1980 • http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 8/3/2013