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Home My WebLink About13-149 I' Authorization Number \I � �` `� 1 (Office Use Only) �;fIIr p .VI 1:113 PIT 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 (��jRV EGL G/1� U.P 1 Q,iti 2. Mailing Address Lj $o 7-/ 4TF ,?V� 3. Telephone: Home Other: CLII,.L. (314) Lis 7— 3E36, 4. Prior experience in transportation of passengers: No�F 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? YES Type of offense Where When &i.c isUG1/I LL IY)A�/ AZDO7 P ,;4 REYQker. IScis>vc eptk4i42qMAII seer goo7 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? NQ Type of Offense Where When • 7. Have you been convicted of any traffic offenses in the last five years? N Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /1//2 Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yet, 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) derk/taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license numlr 05-/4Ai'.51 . 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 wili 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 Applicantr-t�.( Date 7/ 7-•,/, /)/, *.*****e.ax,,.*,t,.**.:t*.......r*r**........ tt.**+war+*«.rr+***rr..x*:*,r ,,,**,tx,.r***rt.*r**::.t...ri#+at*tr*++r.r*...*****r*,tt***. .*. ..***a«.*r*r**.r STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by CA,,,r E. e '0 i,- / . On this h- day of . \ `LJ. otary Public in and for the S ate of Iowa `-) lt-i ******aw*a****a*a******************************************a******a************a**w***************ww *.**wwww* ******wwrw*****..*************** 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 ofd.Ii.- 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. ��-� J / ie - r.4 , 7--- 1 - / 3 Sign ture 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 '/z" (height) and prominently displayed to all passengers. *******w**************************************************************************************************************************************** Office Use Only Approved application DCI report State certified driving record Website update • clerWtaxidnvbadgeapp2010.doc 03/2013 ARTS Page 1 of 2 i f lowa Department of Transportation office of Driver Services (Toll Free)800-532-1121 PO Box 9204,Des Moines,lA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 7/9/2013 DL/ID it: 055AA4589 (IA) Customer it: 3257221 Name: Upton, Gary Eugene Class: C ID Status: VAL Address: 1701 MT PLEASANT ST Audit it: 5520918 DL Status: VAL APT 47 Issue Date: 09/20/2011 CDL Status: None City/State: BURLINGTON, IA 52601 Expiration 05/16/2014 CDL Cert None Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: PO BOX 601 Restrictions: Corrective Lenses Restriction None Date of Birth: 5/16/1963 Supplement: Mailing City/State: BURLINGTON, IA Sex: M 526010601 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/26/2007 12/12/2007 A20 !Deferred Judgment OWI IL 09/05/2007 02/12/2008 B20 Driving While Suspended, Denied, Cancelled, Revoked Des Moines IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation JUR _ 05/26/2007 A98 OWI Test Failure IL Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Disqualified 08/30/2007 08/28/2008 A98 OWI Test Failure IL IA , Revoked 08/30/2007 :02/25/2008 A98 OWI Test Failure IL IA Revoked 04/22/2008 10/17/2008 B25 Driving While Suspended, Denied, Cancelled, Revoked IA IA Name: Upton, Gary Eugene DL/ID: 055AA4589 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: g111 http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 7/9/2013 ARTS Page 2 of 2 S. 7/9/2013 aterezA Office of Driver Services Iowa Department of Transportation Name: Upton, Gary Eugene DL/ID: 055AA4589 http://172.29.254.55/drivers/reports/customerhistory/certifieddrivingrecord.aspx 7/9/2013 Jul. 16. 2013 11 : 31AM Div of Criminal Investigation No. 0343 P. 2/6 Jul, Ih, L1/19 IU:2/A11/1 City Clerk — City of Iowa City No. ib71 P. i i • . • ii :. , , . }�1L�A�IJ Ji Cheek tnF�•N�Sir1}4�p^'�� 'e pCTAdoounCNambor: Lk�a . r ' • QrappirebIo) - To; Ion blvl,ipnofcrhninalmwasttottoa Fronts CITY va TQm. 0757 • Support 06AeuitorrsSurma;l'tpYaor CITY cx.B g7g OPFXCh a1NB.illi 5<rdet - his V. 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LQ--- xowaGz'hn/ns1Sllotory'Reeozdatiewhed, lx01# 0 \'5 \5 Received Time Jul. 15. 2013 10: 264/11„9997 Vt. Jul. 16. 2013 11 : 31AM Div of Criminal Investigation No. 0343 P. 3/6 s IOWA CRIMINAL HISTORY DCI 00813715 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- 2013/07/16 . DCI:00813715 NAME: UPTON,GARY EUGENE DOB SEX RAC HGT WGT EYE HAIR SRN POB 19630516 M W 600 155 HAZ BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD •'+w 01 ARRESTED 20070905 AGENCY: IA0290000 DES MOINES CO SO CHARGE NO- 01 IA STATUTE IA321J.21 DRIVING WHILE LICENSE DENIED OR REVOKED TRIO: DA000PNO1 COURT DISPOSITION AGENCY: IA029015J DES MOINES CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.21 DRIVING WHILE LICENSE DENIED OR REVOKED COURT CASE ID: 08291 SRIN015965 • CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: DA000PNO1 SENTENCE DISP EFF DAT SUSPENDED JAIL OD 20080212 . JAIL l0D 20060212 • FINE $1000 20080212 UNSUPERVISED 1Y 20080212 PROBATION 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 og