The URL can be used to link to this page

Home My WebLink About13-157 Authorization Number / /57 r 1 (Office Use Only) �:.: FiZr 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 52249A/826 (319) 356-5040 (319) 356-5497 FAX First / IJV fiddle 1 Las 1. Name 5"7 /� �Ic"f // 5." L� G /r'liil 2. Mailing Address 2d2 4 Uj v�l.r/? c-�pn /06 3. Telephone: Home 3( yif7 67- Other: 4. Prior experience in transportation of passengers: 7 f`'`G--4-r dLtiC C r`t l "L 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When 3 "Lr of 4-4%7 Fornn. V;,:,/Al ell)r, A ca wig ilAjwMAP, Cou/e, .� /ol aji 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? /1O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? "C;1'�� SE�� Zc4t� .�o1>`'t P Type of offense Where When ,l yzZ, 4/1111/ 11,4 C. /R- Y-rz fY0 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A r 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) n 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 332 /1' 4' 15/ 9s I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number . 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 1 //3 STATE OF IOWA ) COUNTY OF JOHNSON ) // � 9�w Subscribed ±j / and sworn to before me by 5 rtt..cj( - 7j t 1«/hf1 . On this —,Z7 day of 7{-/- Notary ubl Notaryyublic 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). 3 Sig ture of olice Chief or designeeDate 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 1/2" (height) and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerWtaxidrivbadgeapp2010.doc 03/2013 cif Tran p + rtton t ' l% !2t2Vfhtmh1t {loll Free)8M-532-1121 PO 230x'92(#4,DL, Moine- ,R60306-0204 515-241-9124 FAX:515.239.183f Certified Abstract of Driving Record Inquiry Date: 2/21/2013 DL/ID#: 332AE1495 (IA) Customer#: 1925346 Name: Kennen, Samuel Class: D ID Status: None Joseph Address: 308 E BURLINGTON Audit#: 4866587 DL Status: VAL ST APT 106 Issue Date: 12/07/2010 - CDL Status: None City/State: IOWA CITY,IA Expiration Date: 05/03/2014 CDL Cert Status: None 52240 Endorsements: 3 CDL Med Status: None Mailing Address: 308 E BURLINGTON Restrictions: NONE Restriction None None ST APT 106 Date of Birth: 5/3/1973 Mailing IOWA CITY,IA Sex: M City/State: 52240 History Information Convictions 4, Citation Date Conviction Date ACD Explanation County JUR 04/04/2008 06/02/2008 M75 Passing School Bus 52 IA 04/13/2009 04/18/2009 M14 Fall to Obey Traffic 52 IA Sign/Signal 02/09/2010 02/12/2010 072 Fail to Have Vehicle 52 IA Under Control 07/17/2010 08/15/2010 M81 Careless Driving 52 IA 12/12/2011 02/28/2012 M14 Fail to Obey Traffic 52 IA Sign/Signal 10/25/2012 12/04/2012 N04 Fall to Yield to 52 IA Emergency Vehicle • Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 02/09/2010 565881 IA Name: Kennen, Samuel Joseph DL/ID: 332AE1495 • Pursuant to Iowa Code 5321,10, 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: 41 2/21/2013 uc : Ay 3� 5 D. O. T. . eirocre4. Lt - oF•p...� RIVE _ Office of Driver Services Iowa Department of Transporatlon Name: Kennen,Samuel Joseph DL/ID:332AE1495 Feb. 19. 2013 1 :44PM Div of Criminal Investigation No. 3678 P. 7 . Feb'. 8. 2013 11 : 36AM City Clerk - City of Iowa City No. 3205 P. 2 I - • • • ----- ,ykixn •epioii,o--. . . _ .--- .._._ . ..__._. �i 1o�•r�.,. • . eb• .y%.,•�u^ srAT1 O 3VV.A, ,��o''.r#"^% a) . �y• aife -, it r�x>irnai<rs iP 54�k t i•, S, icit, :ef1?:i I' a.liistorr/Record d Cheek r, . � ! •;; N.,.� •. Request Form �j'`�� u ?.-G4r • . I7CIAccountNnmber:• �� —� • . Qfopptirdio) To; TOWA Melon orCrfminalXhvo*ttg'nUon llYqu8 on t ov TotaOTT4' Support OperationrBurou%lit Moor . Cm CLERIC'S OSeBnCL 215'S,7'4 Street Mo R, witat111CY41'_TREBT bavhlorges,Towa 60319 ' (519)7794066 • T017A. CLQ TOPS 52340 (615)125-6000 I'Et , Yhonei . 319-956-510%1 - • llaYi II 9-Rig-s4,97 Ioro requeatIfl arl.loW&CriminalHiefo RdeordCheaicon; _ ' TiastNg]79(mrnde[o. ') - o(MVa.bits�l<1'arne(mandaroty) Middle Nome(ccommeadrd) , ' • l( 244ell 5" / 17mSepti ;Datiootnirt imldoloty) . Cidll(Tek(mnndafory) Sae/Al Seeirri Ntmihr(rewmmmdedl ,95-/03-77 ...3 nada ' Mem. ale , (///- ..2 5»7 Wa4Yepinformatlo tWitfioutasignedwaiyei'homfhesufdeatattheregnasf,atornpiaioaPiming!lti(sfory rcdordutayna0 be 1101003014e3 gel'Codo o£XolvA,Chapter 692,2.S ox'ComPTet9brimina(history reoera Infotmniloh,ag oJLLWea Dy/IA Rums --abfwitt watiersfaneloralronrho.nubleceoTtlioterneedtt— - •--. • . •Brabar_?Bread'ernerebyq(veperrofsvfoofor lhonbovoraquertfe&omtbndocfa ereltotYomniminalmirelyic otdc(teeltwilr ateamatandfCaimino( . Tvostlaarton(DCl).,thyq(minolhlscorydataconeomfngmom,tJe Jutatned4lhollarnyborotontMPllolgdbylnw, _/"--..-----"::. -__C;:::-. c- t 13161Yer$lgltatare, �/' „> Rr—- — , / —mitrso, - • r . . F4 Iowa exhminai!Baton Reeojel Check Results, , {nciii4only) •• I As of D.L‘f l \) aase0choEtaprovidednamearrddateofbiuth ovealed; ' ; ;°`: t • ' ' Ej No Iowa G4hnillalIljstoxyllecordfbund withDCl . Fr Iowa OrlrainslHistoxyRecord attached;DCX# )-ASI 531 . — • i . pCIhaitialy_ P rolnnd T;mn-.Foh A —7a19-11 . AAAM AIA 7Fa7 Feb. 19. 2013 1 :45PM Div of Criminal Investigation No. 3678 P. 8 IOWA CRIMINAL HISTORY DCI 00451531 • MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED- 2013/02/19 SCI:00451531 NAME: KENNEN,SAMUEL JOE KENNEN,SAMUEL JOSEPH KENNON,SAMUEL JOSEPH DOE SEX RAC HGT WGT EYE HAIR SKN POB 19730503 M W 603 190 GRN BRO PAR TN ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 19921218 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRIO: L43115801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VER WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L43115801 RESTITUTION SENTENCE DISP EFF DAT JAIL 48H 19930910 FINE $500 19930910 02 ARRESTED 19950326 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPEND TRK#: 014624201 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 014624201 SENTENCE DISP EPP DAT FINE $250 19950519 03 ARRESTED 19950406 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION TRK#: 014626201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION Feb. 19. 2013 1 :45PM Div of Criminal Investigation No. 3678 P. 9 DCI 00451531 PAGE 2 OF 3 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 014626201 SENTENCE DISP EFF DAT FIRE $300 19950519 04 ARRESTED 19950524 AGENCY: IA0160000 CEDAR CO SO CHARGE NO- 01 IA STATUTE IA321A-32 DRIVING WHILE LICENSE SUSPENDED TRK#: 012726701 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 01 IA STATUTE 1A321A-32 DRIVING WHILE LICENSE SUSPENDED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 012726701 SENTENCE DISP EFF DAT PLEAD GUILTY • 19950811 FINE $350 19950811 ARRESTED 19960417 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401(3) POSSESSION/SCHEDULE I/MARIJUANA TRK#: 024159501 CHARGE NO- 02 IA STATUTE IA727-2 SALE OF FIREWORKS TRK#: 024159502 ' COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-401-3-2 POSSESSION /CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 024159501 SENTENCE DISP EFF DAT FINE $300 19960906 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA727-2 SALE OP FIREWORKS CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 024159502 SENTENCE DISP EFF DAT FINE $250 19960906 Feb. 19. 2013 1 :45PM Div of Criminal Investigation No. 3678 P. 10 DCI 00451531 PAGE 3 OP 3 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECORD 'AINTAINED 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