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Home My WebLink About13-168 Authorization Number 1 3 —1 a (Office Use Only) itt `III tl -01144—mosa Air 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 Irst Middle Last 1. Name Ci\L�. AO ('('.,(�1 C CA,rkill 2. Mailing Address 10'3 Oe CC k.,&A- 3. Telephone: Home 7 r i rU Other. 4. Prior experience in transportation of passengers: '3 f S, 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? les Type of offense Where tWhen ire CP4 t 0‘\) I>°rie(4 [ �e' fS 056 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ;VC Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? l.� ' Type of offense Where J When [[ 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /VD 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) (\I'D 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) cler1 axidrivbadg 03/2013 1 I hereby certify that I have iss9ed to me by the Iowa Department of Transportation a valid Chauffeur's license number ,7,74Q0 ({ms . I understand that if I falsely answer any questions in this application,'7hat this application may e denied. I understand that if I falsely answer any of the questions in this application, that this application MI 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 Z�e ` / Date —/ --J STATE OF IOWA COUNTY OF JOHNSON ) S b•cribed and sworn to Aefore me by - /14C�Z a✓ O c i n . On this / � � day of 7171 1 I 4 KELLIE K.TUTTLE Notary Public in and for the State of Iowa a , Ae 7 Commission iNuinLvr221110 My Coom issi Expires ************************************ * **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). Sign ure of P 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. ) LG/� /[ /� -f' L, C� � / — �. � Signatur 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 derk/taxidrivbadgeapp2010 doc 03/2013 Aug. 12. 2013,11 :50AM , Div of Criminal Investigation ` No. 3217'' r P. 2'. • , • r. • I.- tou3, IN..Jun1YI r• vIty U1c, n 'ul-!p u'I IVua b.I.6S' NU. JI{'I r. ' ( . • ' 4 .. ' ' . • ' • V ' ' , , • I ' , , • 1 - I . , . . ' , ', • •.. , . r . . • . 1 r I , f., '.. . I , 1 . ..' . • r I ,.• 1 . . . ' %; 1,• kl is�. ' , . , ••��r�.�••QQ11\\ �r //'��.,L��,1yI,'.(�nty�1/y 1' • r ��tiAiP0 r ♦ 1 , ',Al ' qY 1. StAIIu ° JLnO/Y�[MryNr V. p. . • I I• 4Jyyp!,,�4,•�'.4('''h.�'PQ . 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' 0191 uca an(t) As of 5& /l I (3 9 a Sagtab o thtr 1Jrovlfiednamo thud Ate a bkth.TeveaTedi ' kp , Na�owgCiirnnalliistoryRecordibbSwitlDCt• , , I Li' Xo' • WAaIN'lsfocyRecord at(Aohed,T)CXeR " • Received lile' Aug; 1. 201316,50AMf,'o, 2245 - Iowa Department of Transportation 08,1) Office of Driver Services (foil Free)800-532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FM:515-239-1837 Certified Abstract off Driving Record Inquiry Date: 8/1/2013 DL/ID #: 445AF7886 (IA) Customer#: 5603884 Name: Carodine, Emcee Nayram Class: D ID Status: None Address: 703 PERRY CT Audit#: 5857043 DL Status: VAL Issue Date: 03/14/2012 COL Status: None City/State: IOWA CITY, IA 522455243 Expiration Date: 05/14/2015 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 703 PERRY CT Restrictions: NONE Restriction None Date of Birth: 5/14/1976 Supplement: Mailing City/State: IOWA CITY, IA 522455243 Sex: II History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 02/24/2012 03/19/2012 RS92 Speed J• ohnson IA' 03/01/2012 03/28/2012 592 Speed Johnson IA 03/01/2012 03/28/2012 F04 Seat Belt Violation 'Johnson ,IA i 06/08/2012 08/31/2012 S92 Speed Johnson IA 07/27/2012 10/30/2012 F04 ,Seat Belt Violation Johnson IA Name: Carodine, Emcee Nayram DL/ID:445AF7886 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: itNlClf gar" 8/1/2013 : Dlal Cadf4 CareeseiritVak.. /,' : Ii1q� igt., e of D Services 1RsIowcrtment of Transportation Name: Carodine, Emcee Nayram DL/ID:445AF7886