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Home My WebLink About13-169 Authorization Number ( 3 -- I I _ 1 (Office Use Only) 3iAIM ii11 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 Middle Last 1. Name SLI -f- . /,k3 2. Mailing Address/ ` 038 6 _E./L C 0 r26 `,tl tA S G-4-7/ 7 CR I 3. Telephone: Home t1 80`� Other: 3 ( r L, 7 ) -- t 7 f y 4. Prior experience in transportation of passengers: A G{v-t -✓ s L ( S//1( 2 (-7° 7 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Ye) Type of offense Where When Get l� c-,S C""1-7 � 7 CrI) 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 ,Veed C-01 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ) l 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) 1/1 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) 03/2013 I hereby certify that I v-Q issued to me by the Iowa Department of Transportation a valid Chauffeur's license number e Z S . 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 � � Date / Z/,3 STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to,I efore me by � v(rd. / aP / n . On this day of J 7(4./ , (� at"t KELLIE K.TUTTLE NotaryPublic in and for the State of Iowa rnmmiccinn Number 221819 MyCo mis, nI pires ow 1- `-- ********************************************* *** ********************************************************************************************** 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). (02// -5 nater olive 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. Signatur 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/z" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp2010.doc 03/2013 Iowa Department of Transportation if&1office of Oliver 8eMces (Toll Free)800-532-1121 PO Box 9204,Des Manus,IA 50306.9244515. FAX 515 289.183244-91247 Certified Abstract of Driving Record Inquiry Date: 8/9/2013 DL/ID#: 059889825 (IA) Customer#: 1387263 Name: Maeglin, David Otto Class: D ID Status: None Address: 2038 DEERFIELD RD Audit#: 5187550 DL Status: VAL Issue Date: 04/28/2011 CDL Status: None City/State: MUSCATINE,IA Expiration Date: 12/11/2016 CDL Cert Status: None 527618329 Endorsements: 3 CDL Med Status: None Mailing Address: 2038 DEERFIELD RD Restrictions: Corrective Lenses Restriction None Supplement: Date of Birth: 12/11/1959 Mailing MUSCATINE,IA Sex: M City/State: 527618329 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 02/14/2002 03/26/2002 A20 Deferred Judgment Muscatine IA OWI 05/12/2009 07/15/2009 592 Speed Johnson IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurance ACD Explanation JUR 02/14/2002 A90 OWI Test Failure IA Sanctions [Type Effective End ACD Explanation Occurrence JUR JUR Revoked .02/25/2002 08/24/2002 A90 OWI Test Failure IA IA Name: Maeglin,David Otto DL/ID: 0598B9825 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: 0142if 8/9/2013 � . ....,dfphr -' IOWA -to g 411. 'eheSPCL14 111yh � pryo Office of Driver Services Iowa Department of Transporation Name: Maeglin, David Otto DL/ID: 059889825 State of Iowa OF Division of Criminal Investigation 4A , 215 E 7th St ° •' ° r IOWA ► Des Moines IA 50319 • °,;:•.'7„ o;:•a' fi:<i'• g A AV Ph.515-725-6066 Fax 515-725-6080 Iowa Criminal History Record Check cR'""" � Walk-In Request Your name ' /0-✓+ 9 OTTQ 4'14E6L//0 Address 9-035 City/State/Zip /v1 tnS C 01-TI'JC _TO Li/PfSl-7(0 I Fill in all shaded areas. Phone# 319- L71 - f7ry Requesting an Iowa criminal history record check on: Last Name Apellido(mandatory) First Name Primer Nombre(mandatory) Middle Name Segundo Nombre(recommended) MAC. Lrid >WO o / -7-0 Date of Birth Fecha Nacimiento(mandatory) Gender Genero(mandatory) Social Security Number(recommended) /74/( /(7c7 Male ❑Female *32 _f3, Waiver Signature Firma(If the request is on yourself,please sign. If the request is on someone else,write N/A.) De-0 to toetA 4.(273€ Results DC]USE ONLY As of \\LIA� , a name and date of birth check revealed: ❑No record found AVCJRecord attached, DCI# 40t \1°10 DCI initials Receipt Number of requests 1, x $15.00 per last name=Total amount$ Method of payment: tPfash ❑money order ❑check# ❑MasterCard or Visa Cardholder's name Last 4 digits of MC or Visa DCI initials V-17:7 Credit Card Number# Exp. Date w IOWA CRIMINAL HISTORY DCI 00491790 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/07/16 DCI:00491790 NAME: MAEGLIN,DAVID OTTO DOB SEX RAC HGT WGT EYE HAIR SKN POB 19591211 M W 511 185 GRN BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 19941122 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA708-2A-2B SIMPLE DOMESTIC ABUSE TRK#: 012603801 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA708-2A-2B SIMPLE DOMESTIC ASSAULT TRK#: 012603801 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 6M 19950127 02 ARRESTED 20020214 AGENCY: IA0700000 MUSCATINE CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 1ST TRK#: 061312001 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 (A) OPER VEH WH INT (OWI) / 1ST OFF COURT CASE ID: 07701 OWCR023499 CHARGE CLASS: NON CONVICTION TRK#: 061312001 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20020320 PROBATION 18M 20020320 COMMUNITY SERVICE 40H 20020320 DISCHARGED FROM 20031021 DEFERRED JUDGEMENT 03 ARRESTED 20030615 AGENCY: IA0700000 MUSCATINE CO SO CHARGE NO- 01 IA STATUTE IA708.2A(4) DOMESTIC ABUSE 3RD TRK#: M00167401 COURT DISPOSITION DCI 00491790 PAGE 2 OF 2 AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA708.2A(2) (B) DOMESTIC ABUSE ASSAULT WITHOUT INTENT CAUSING INJURY COURT CASE ID: 07701 AGCR026983 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: M00167401 SENTENCE DISP EFF DAT TIME SERVED 2D 20030819 SUSPENDED JAIL 60D 20030819 JAIL 62D 20030819 FINE $250 20030819 PROBATION 18M 20030819 04 ARRESTED 20040129 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401 (5) FOSS CONTROL SUBSTANCE I TRK#: 101070401 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 SRCR067657 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101070401 LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT SUSPENDED JAIL 30D 20040514 JAIL 30D 20040514 FINE $250 20040514 PROBATION 1Y 20040514 COMMUNITY SERVICE 25H 20040514 AN ARREST1WITHOUT 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