The URL can be used to link to this page

Home My WebLink About13-146 Authorization Number /3 - P746 1 = 1 (Office Use Only) aszingt- 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) 356-504 0 CAU-- q7--)041, (319) 356-5497 FAX First Middle Last 1. Name C. tf ve LS TOP/4E Ge--. /{-AJ icpAiY Kf'cY� 2. Mailing Address `fc) Soccr-( AJE /0 H- err y, 3. Telephone: Home 102— - 3 26 7 Other: 4. Prior experience in transportation of passengers: ao 4- y ( o FF c er 6 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? A3 n Type of offense Where When 6. Have you ben convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? A; 0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? A L) Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? N-(1) Type of offense Where When 9. Have yQu ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) U 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) clerk/taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 96 3 7/e, . 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) -gyp Signature of Applicant • ` Date /�y 1 3 ************************************************************************************************************************************************ STATE OF IOWA COUNTY OF JOHNSON ) Subscri;d and sworn to before me by C--:-‘"r S oph.�Y-- \ick . On this \-4 .k day of 3 "C.). � 3 Nota ' .blic in and for the State of owa .713 1"f 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). Si nature 017 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. SignatI re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 51/2" (height)and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update • clerks axidrivbadgeapp2010.doc 03/2013 Id . Iowa Department of Transportation till% R. Office of Driver Services (Toil Free)800-532-1121 PO Box 9204,Des Moines,IA 50396-9204 515-244-9124 FAX:515-239-1937 • Certified Abstract of Driving Record Inquiry Date: 5/8/2012 DL/ID #: 964663716 (IA) Customer#: 5159807 Name: Kaye, Christopher Class: D ID Status: ; None Anthony ' Address: 2007 W 3RD ST Audit#: 5966275 DL Status: VAL Issue Date: 05/08/2012 CDL Status: VAL City/State: WATERLOO, IA Expiration 03/26/2015 CDL Cert Non-Excepted 507012903 Date: Status: Interstate Endorsements: 3CDL Med Certified Status: Mailing Address: 1511 LAS VEGAS BLVD Restrictions: cormitercial Instruction Resp etion ExpiresDL Instruction 1ruction Permit N Date of Birth: 3/26/1968 Mailing City/State: LAS VEGAS, NV Sex: M 891011120 CDL Medical Examiner's Certificate • Certificate Specifics Explanations • . .. ...- _ ......_. Medical Examiner First NameJeffrey Medical Examiner Middle NameJames Medical Examiner Last Name Curnes Medical Examiner License Number 3385 „ ,_•, ...... Medical Examiner Jurisdiction ..„ _...,„. .I__,_. ...-., .... - •- - •- IA _._.. .cExaminer (319) 369 8153 Medical Examr Phone ......... __ ... Medical Examiner Type Osteopathic Doctor ,..., ; Medical Certificate Issued Date _ 04/23/2012 . Medical 04/23/2014 Certificate Expiration Date - ---- ._ ' Date Added to CDLIS Driving Record 05/08/2012 . . History Information Convictions Citation Date Conviction Date ACD Explanation ,...County -3UR„ ._ 04/07/2008 05/05/2008 1364 'No Insurance Card •7 • ,IA 08/13/2010 09/13/2010 •• 'Improper Registration _ -7 IA ._ ....._ ... N .... 'NV 01/04/2011 :09/29/2011 ;D36 'No Insurance Card Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date. Case Number JUR 04/07/2008 .435661 IA Sanctions . • /r Y T f , Type Effective End ACO Explanation Occurrence JUR 7UR Suspended 06/11/2008 '03/17/2009 D38 Fall to Post Security for an Accident IA ,IA Name: Kaye, Christopher Anthony DL/ID: 964683716 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: 6� --- EHICLE •!/'/i4 5/8/2012 IOWA 2' . %II D. O. T.41 .+ . ceFOces BIVERS`S OfficIowaeDepartme tofiTransportation • Name: Kaye, Christopher Anthony DL/ID: 964663716 K . Jul. 10. 2013 10:57AM • Div of Criminal Investigation , - No, 9708 P. 1/3 Zvi. n.• [vii 7OMNI: „Ily.-u 1 e,rK - ,!.t !y .) I Iuta.a t, I !IV 'k0. 10)) , E. ,z - •1. 1 i I. ' • r1 t 1 • . ., 1 F , 1! • 1 . , 1 1 1. i 1 . r1 , ,, • I • • f °�1\ qLp >' A�lit. J."-1 1Yy . .. lvL�ye'�'�� 4r Gq] mp t ��TT t511J/C�/7� ,aa.r, 1 l,,�I ��, x 17 ® JL41' � i�v,�,rl'�'t:��,J , 1 'lU , I• , y •IC99°°° , �s�. L; IA 'tt fl d 8 bvz�ri��.� ��l r)X"� eeo Check eC s ilteit;•w r•., �;: v,'foai,f,. ` .J Request 2S� 0$'9ffl ni r,.,`�4�F XYCIA.epollnCNnmhor, /vim -'rte • To: xotva!aIvrslon of Criminal Xnv ofigatfori • • k`roms act nx, TARA, nrvt • Support OporafionsMum,I'lPTaa. • o -z cr•=1*6 o )self x151;,7'"Street 410RSsaMMOr g_ rem_ , ) osMdnas,Totva do319 651012g,6a66 •; ' IOWA, 1.),7x rgt1a , $27,4p . (515)12,5(Off 0 klat - .pyione, wig-45(,-•Sft41 , p•ax1 31a-956-.5497 r .1drare,pestis, °aloftCriminalHi o ,ecordCheake17; , ' LasttNrgirte mendnloo) ' Eir'etnitte eodofa . • 1vlddioldan o rocomnsndnn) . Ayr .. . :,. . , lie t S�PrztEg2 Oil A) Y • "Pao of131rtla mrn4rpry) Geittlex andelay) Soeta/geom.( NOtitherfroonnunendad D3 0210 /968' .[ SIe ' EfFemee 7— — 00t 1vnxbe,Iafor'N1adory;MilEfro utas(lwa;YerrtyontMosuhteator,tho1egnost atom/fate clilinglUrfa rymem!May- � •+•n. 1 - of -a, a. e . , 0 a r :1L - >' rrtldstoiyraeorat b1mation,e :1,••:1 ,• .iv, 1 'to, • ohtaco t ers!,nature A.. 1t e,sobjectofeccare•'i4st5 FrahreitkeigarPniedynfro pdradprogkilionbovorapesirogenc.raflawnf aF uYoW4odnibunlf!Istoly,(eco(dnfleed'tithTcnArereaogcriminal • rnyasttgeaon pop,.pay reltheuatloyeaieacndvmt :mo • tismiLlnlaadAy ifto)ormeybarefcptcdav elfoW:d`(Vim, T'SerStgnalure; r o2 rJt ( � .v _ Sia - t& Zovwa erfrn.TnnpiJfatoryRecaro Cheek Resu1t , • Ncluroonb) As of i— /0-a a aegtoit of theintvlded nems and dace ol;birthlevea7ody : -., . til'olowarIrojnuI istotyRecordtiwctwithDC2 I 0 I.Iowa GrlminaI BBlsipzy Rc ozd aftaohed,D CX f, • ^, r • • e;, Received Time Jul. 8. 2013 9: 03AM No, O 4 •