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Home My WebLink About13-164 • Authorization Number l 3-- 1101f • : 1 (Office Use Only) alle Oil I ZIT 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 1. Name 1,. ' :it ►'`\ (\A. 2. Mailing Address J � Ct�1 7 3 cc�� o , 3. Telephone: Home C,2 -, /?74( Other: 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? ,i-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? v (t)(:) Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? f�9� Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? (/-t J Type of offense Where When ��,d` . 1 ,�C,�p , ��,t.; � , 1 9. Have you ever11applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) A) L? 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) Gerk/laxidrivbadg 03/2013 bob , I hereby certify that I have issued to,me by the Iowa Department of Transportation a valid Chauffeur's license numbs; 1�;) i(;6L 4.61 arf rf . c . I understand that if I falsely answer any questions in this application, that this application may be d ied. I understand that if I falsely answer any of the questions in this application, that this application will be denied. I agree- at 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 t>J ; i i.', 44.. G?lYt e- (;) Date - )o( J -- STATE OF IOWA COUNTY OF JOHNSON ) . Subscribed and sworn to before me by ‘N\•.ern Sc-\\\A„,-•C,- , On this day of yyt- clotary P 'No in and for the of Iowa '11304 ******************************************************.***************************************************************************************** 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). ignat 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. - igna`-ttre 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 Uerkltaxidnvbadgeapp2010.doc 03/2013 OF PU State of Iowa Viltto_Fiti t, �ff ,9 4< 9 .1.- e' ti��C �s Division of Criminal Investigation ;5 + ti fr v 215E7r"St <^/! ib °' t ri o IOWA I )S. Des Moines IA 50319 o x ,:":'` n z' ,t q I a Ph.515-725-6066 Fax 515-725-6080 e ce. 'CO` , �c9 . h e J 96 rip/N p��. Iowa Criminal History Record Check c@rMl j`? ` Walk-In Request Your name Id ;it ,Awt C;-7't=?,r1 r( Address I 7 2, (r J'�,r MI,�s(c-1ln-z R,l City/State/Zip i.3 c -7 S :i,).^0,VI.r ti S ASs Fill in all shaded areas. Phone# ; . y) -. \t-1c- r2$ i Z T y Requesting an Iowa criminal history record check on: Last Name Apellido(mandatory) First Name Primer Nombre(mandatory) Middle Name Segundo Nombre(recommended) C_et-Ct; tGel W ll\•eA.wk. IA Date of Birth Fecha Nacimiento(mandatory) Gender Genera(mandatory) Social Security Number (recommended) J 11'6 ` 2� 2( / 7C QNlale ❑Female 11 / t _ 7� Waiver Signature Firma(If the request is on yourself,please sign. If the request is on someone else,write N/A.) -f I � //l �� ,'ll i/ �Cr%[./r'f F` . P( : Results DCI USE ONLY As of - 3 - I 3 , a name and date of birth check revealed: ; ❑No record found Record attached, DCI# p i LI LI I q DCI initials Receipt Number of requests I x $15.00 per last name=Total amount$ I 5.00 Method of payment: Ocash ❑money order 0 check# 0 MasterCard or Visa Cardholder's name Last 4 digits of MC or Visa DCI initials Credit Card Number# Exp. Date IOWA CRIMINAL HISTORY DCI 00814414 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/08/02 DCI:00814414 NAME: SATTERFIELD,WILLIAM M DOB SEX RAC HGT WGT EYE HAIR SKN POB 19760820 M W 510 140 BLU BRO IA 'ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 20070916 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J.2 (A) OPER VEH WH INT (OWI) / 1ST OFFENSE TRK#: 1A002D301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 (A) OPER VEH WH INT (OWI) / 1ST OFFENSE COURT CASE ID: 06521 OWCR080837 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A002D301 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 1Y 20080227 PROBATION 1Y 20080227 REVOKED 20090310 JAIL 7D FINE $1250 SUSPENDED FINE $625 02 ARRESTED 20080411 AGENCY: IA0520500 NORTH LIBERTY PD CHARGE NO- 01 IA STATUTE IA321J.21 DRIVING WHILE LICENSE DENIED OR REVOKED TRK#: 1A003VF01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.21 DRIVING WHILE LICENSE DENIED OR REVOKED COURT CASE ID: 06521 SRCR083019 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A003VF01 SENTENCE DISP EFF DAT FINE $1000 20080617 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 EN *I AGENCIES BY THE DCI. IN 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 Iowa Department of Transportation pq• Office of Dliver Services (Toll Free)809-532-1121 PO Box 9204,Des Maines,IA 50306-9204 515-244-9124 411110 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/6/2013 DL/ID#: 606YY8919 (IA) Customer#: 1381354 Name: Satterfield,William M Class: D ID Status: EXP Address: 173 CEDAR MUSCATINE RD Audit#1 7207440 DL Status: VAL Issue Date: 08/06/2013 CDL Status: None City/State: WEST BRANCH, IA 523588621 Expiration Date: 08/20/2016 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 173 CEDAR MUSCATINE RD Restrictions: NONE Restriction None Date of Birth: 8/20/1976 Supplement: Mailing City/State: WEST BRANCH,IA 523588621 Sex: M History Information Convictions Crts[ion Date Conviction Date ACD Explanation County JUR 04/11/2008 06/18/2008 B20 Driving While Suspended, Denied, Cancelled, Revoked Johnson IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation JUR 09/15/2007 A98 OWI Test Failure IA Sanctions T,pe Effective End ACD Explanation Occurrence JUR JUR Revoked 12/01/2007 05/28/2008 A98 OWI Test Failure IA IA Revoked 08/05/2008 01/31/2009 B25 Driving While Suspended, Denied,Cancelled, Revoked IA IA Suspended 08/15/2008 03/31/2009 D53 Non-Payment of Iowa Fine IA IA Suspended 01/09/2009 07/16/2009 D53 Non-Payment of Iowa Fine IA IA Name: Satterfield,William M DL/ID:606YY8919 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: 'it-.n'''f pj% I 8/6/2013 3afIOWA 'i is `ucf Office of Driver Services !lief S` Iowa Department of Transportation Name: Satterfield,William M DL/ID: 606YY8919