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Home My WebLink About13-156 Authorization Number 1 -- 14 (-' r 1 (Office Use Only) Illtr�tp ts Atimmaifellr 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 Ci . a 52240-1826 ( 19) 356-5040 (319) 356-54 7 FAX FirstA MipIdle tasty 1. Name ' V� OSS ✓� 1 Z 2. Mailing Address \ C.. y £ IJ ' c L 3. Telephone: Home. ) - 3rrj(-(,�� D S Other. ') H — y 00 3 — o 4. Prior experience in transportation of passengers: j\`(-) 11)e 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? t! 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?.. Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Y1 Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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) 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) clerkltaxidrivbadg 03/2013 I rherepprtify hatI_ h v�issued to me by the Iowa Department of Transportation a valid Chauffeur's license number �� tryJ_ ) , . 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 pr visions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant Date ?/a f//3 STATE OF IOWA COUNTY OF JOHNSON ) -14‘Subscribed and sworn to before me by q �rr� R =Y{ . On this '9 day of co` c:247/3 7� +offal(�s SONDRAE FORT L • Commission Number NotaryPublic in and for the State of Iowa M� Expires ire&Commission Ex ************************************************************************************************************************************************ 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). 7- 3 Signature ofoliP ce 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. 1 � �✓ ,_AJ 7 - `I - /'3 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 • clerkRaxidrivbadgeapp2010.doc 03/2013 Iowa Department of Transportation OfficeoWriverServices ;Toil Free)800-532-112.i • PO Box 9204 Des Wales,IA 511346-3244 515-244-9124 FAX 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 7/9/2013 DL/ID#: 555XX6053 (IA) Customer#: 3250094 Name: Ramirez,Alma Rosa Class: C ID Status: None Address: 503 ELKHORN TRL Audit#: 6618474 DL Status: VAL Issue Date: 01/15/2013 CDL Status: None City/State: IOWA CITY,IA Expiration 01/14/2018 CDL Cert None 522409208 Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: 503 ELKHORN TRL Restrictions: NONE Restriction None Date of Birth: 1/14/1961 Supplement: Mailing City/State: IOWA CITY,IA Sex: F 522409208 History Information Convictions Citation Date Conviction Date ACD Explanation County JIJR 09/12/2008 10/03/2008 M14 Fail to Obey Traffic Sign/Signal _ Johnson IA _3 03/18/2011 104/15/2011 592 Speed (10 mph&under in 35-55 mph zone) Johnson IA I Name:Ramirez,Alma Rosa DL/ID:555XX6053 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: f. * **.4/j, 7/9/2013 Ct IOWA '4� # r` ',sit O. T.1544 "ter 03 §�Of gR S : Office of Driver Services �h`Ar.�.oIowa Department of Transportation Name: Ramirez,Alma Rosa DL/ID: 555XX6053 Jul. 24. 2013 ' 1 :45PM •• Div of Criminal Investigation • • , - No, 1181 . P. 1 .1, 441. I?, LV I.3' II': %HFillfi • .•k,I t y LI efK"1 'lly. 01 1o19a Lily - . Ivo: 5007 . 1",( •2 , . , f , . , .1 ' , . .� •• .. I 1 _ . . 1 • 1 , . . • • IN • • • ��- `�'t l • , q� c,f LI) . • , • btt�nail d.Et tocyRecoS 'Cheek • , - 1.0 . li:;, ` ARG/1/raAl,�AF' Roquegt Form , - �d o la Iyavli ft • ACA.000untNamfier; . '. (? 0 '.- 4 . • 1 , Qtappftcahts) To:, Iowa ilitrakhofCam)r1K1Xlivostfg t(oh Prom CITY ov Tan ear • Support°DeratlensPoyang).1)( loor - CM CLESK'5 O 2ZGE; aXSE,7'1',afreet • 410 ia bra lMphlQsyl'ow 503/9 ' . (s15)72 -d000 • snwA: civic =rrcrA szz�a khona: 9'N-356-5044 • 110X: 319-7CK— &O7 1'Amre�qypost(n aaX414a,Ctiminalklistory.Record Cho ckon; • . • ThatN'a1Yre mandatory} ' .FirstNamer IaedAfe MiddleN&nleaecamosndbal . , ti , ' Data ogSlrtt/mold/mry) (afelydex(mandalop) 80chi beelXl'ICyNbInhorframmmendod} 3 H ( C( _ (9 (e ( ❑ do 'l► Q12Xfile , q6-t— a 6-'----2 ) 0( 0 • . r. rrnaPtn,y:-p1i li..atpaa�1 711YealnmtbAsubfroot4;h.,asot, ,,,,plctBgkkainA7fiiearynatd-uray. . Ta0raleaogbra,nor Coda edam)Chal7ter(93,2.NoPp orinr(nallitvloryrecord biroxmn/lon,avaliewddZylhwr,a(cypys ' °l ath0vyofroesIgaa(uYd11•opttX(olarblootoX'Yhei'ogU h' • Tllellies'kel'e(i:ref lbercbygfve permlar(on'@tataobovayaqueilhgo&1'oi9T to vondpcf wi IOWA Piminnf fdstoryteeo/d 4044. lblpaDivislog of csfmrnM Tnyasl7Antroe(pcq.,uyrt(,ntnelhratory6aftood&omf lodmtIonarnlofnedf,f'tDDOtmnyb of -•� o'eitowcdbyPim WajlerSXgrtal[re: _+ 4 ' k•�.,��► . ,.-to. . 1k. pL,,_,— "GYM Critialbaiyjjat.rryRecari Choc_ Resrx��. , • (gclurdenb> As of �� y"13 4,11.seal-0140£thepxotld'ednQaneaid ddtaof•bith.eveaiod; : - a NOjowacrimiziolgiatoiykecordMounawitd)or it,nGDnlnal;S�'lscovRecoxdattagl d,11CU Y3011 •Qa,.. ,..A Time J., 1Q 11111 11 , K7ANJYMA 076Q /kb" Jul. 24. 2013 1 :45PM Div of Criminal Investigation No. 1181 P. 2 IOWA CRIMINAL HISTORY DCI 00430115 • MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/07/24 DCI:00430115 NAME:. ORAMILLO,ALMA ROSA RAMIREZ,ALMA ROSE DOB SEX RAC HGT WGT EYE HAIR SRN POE 19610114 F W 503 160 BRO HLK LER MM • ADDITIONAL IDENTIPIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 19911206 AGENCY: IA0250000 DALLAS CO SO CHARGE NO- 01 IA STATUTE IA321-218 DRIVE UNDER SUSPEND TRIO: L40927101 COURT DISPOSITION AGENCY: IA025015.1 DALLAS CO DIST COURT COUNT NO- 01 IA STATUTE IA321-218 DRIVING UNDER SUSPENSION TRK#: L40927101 SENTENCE DISP EFF DAT PLEAD GUILTY 19911207 FINE $85 19911207 02 ARRESTED 19920314 AGENCY: IA0060000 TAMA CO SO CHARGE NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPEND TRK#: L40927201 COURT DISPOSITION AGENCY: IA086015J TAMA CO DIST COURT COUNT NO- 01 IA STATUTE IA321A.32(1) DRIVE WITH SUSPENDED/DENIED/REVOKEDLICENSE OR REGISTRATION • CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: L40927201 SENTENCE DISP EFF DAT JAIL 2D 19920519 PINE $200 19920519 COURT COSTS 19920519 COMMUNITY SERVICE 52H 19920519 03 ARRESTED 20111112 AGENCY: IA0700200 WEST LIBERTY PD CHARGE NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION - 1978 TRK#: MA0064H01 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMPTION / INTOXICATION - 1978 . Ju1. 24. 2013 1 :45PM Div of Criminal Investigation No, 1181 P. 3 • DCI 00430115 PAGE 2 OF 2 COURT CASE ID: 07701 SMCR046196 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: MA0064H01 SENTENCE DISP EFF DAT FINE $100 20111118 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 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