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Home My WebLink About13-136 Authorization Number • r 1 (Office Use Only) CMZEIT2W-tha m 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 52240-1126 (319) 356:311-40 j r 14° j-1 (319) 356-5497 FAX First Middle Last 1. Name Anifiolc15 ycar-F- t .•�t,:'rt 2. Mailing Address 111 5 Oc/07-0 3. Telephone: Home ' I`1 1-I11 Gt'C - 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? Type of offense Where When S.A 011 )61) Def)-1-c be rl.ia N ;4 G C 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? "'v Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? `(' Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Ai° 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) clerk/ta ddrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 10aY'fc17 50 . 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 Applicant1fi1r6 - 4--'t /1.1/►1(�'`� Date CO' / fj// STATE OF IOWA COUNTY OF JOHNSON ) / Subs9ribed and sworn tp before me by lam c• l a/as �y i/1- /e /( . On this -P-5-k day of Y�tq�s KELLIE K.TUTTLE l i l /„c7-/(-(2-t `—t • C commission Number 221819 Notary Public 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 Of welfare of residents of the City of Iowa City(Title 5, Chapter 2, City Code). b 2(;/3 nature 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. Signature o City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/z" (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 clerkltaxidrivbadgeapp2010 doc 03/2013 trillIowa Department of Transportation ..fir Office of Driver Services (Toll Free)809-532-1121 4 PO Box 9204,Des Moines,IA 50305-9204 515-244-9124 FAX 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 6/21/2013 DL/ID#: 700YY9754(IA) Customer#: 377160 Name: Trimbell, Nicholas Scott Class: D ID Status: None Address: 636 S DODGE ST APT 6 Audit#: 5200022 DL Status: VAL Issue Date: 05/04/2011 CDL Status: None City/State: IOWA CITY, IA 522404836 Expiration Date: 07/13/2016 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 636 S DODGE ST APT 6 Restrictions: NONE Restriction None Date of Birth: 7/13/1978 Supplement: Mailing City/State: IOWA CITY, IA 522404836 Sett: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/09/200301/05/2_004 :A20 'Operating While Intoxicated i7 ;IA 10/26/2012 }12/11/2012 ''4 :Fail to Obey Traffic Sign/Signal i52 _IA Operating While Intoxicated Test Refusal/Test Failure Violations OccurrenceACD Explanation JUR __. .__„_._._........_...._... _..__._v__.__ 05/09/2003 A90 OWI Test Failure TA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked =05/20/2003 /11/16/2003 ;A90 ;OWI Test Failure ;IA IA Name:Trimbell, Nicholas Scott DL/ID: 700YY9754 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: �'l0; ‘4 6/21/2013 30' IOWA *°i • 4 a i r:',�i8,fD81osR`mss mceofa Driver rtmrSernt vices nsportation Name:Trimbell, Nicholas Scott DL/ID: 700YY9754 . Jun. 19. 2013 10: 12AM Div of Criminal Investigation No. 7492 P. 8 Jun. 17, 2013 2: 26PM City Clerk - City of Iowa City No, 3560 P. 2 • • r1, • u p 1 ;$ J 1. rz v�r� STATE 4&,601;11/i/ " •1 W U�, 11 • '.�\ �b'or;o .Vik ki Pihi utt - b'nmlrlal.Elstory ze to �Recordl Cheek szv I'A IEI:T a • orm • . PDX Aaoountiv�tmber: TOda •"- P • PPS(MEIN— . • ToaLowe blWslohoaf Criminal)hva&ttgetteh Frew ern' (ThIolA an • Support operattonsBaton%111.13taor • omit ®a 'S oakrcz 21er,rarest 4.1a It vrAstmgacotY aux . , beslla'ph16s Xowg SOY19 ' 015)=add Yr11 a (06)12.s-on T+aTs . 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WA lverSlgltalare; f ' _owa Cxhnfnal Mater Chock Results , . perm:06) 4,6,of I C a search oftke,provi&edname aid date of bittha'ovoaled; ' ,' • .. ...._ ; - .1 0' No Iowa Criminal-1istol:yRecord.foUndwithDCT , 1� of GlminaIPlinio/Recordattached,Daft � Ji-� 4,nd SRI 1 rA n _ 1 T'_ _ I.._ 1l nn 10 1.00 aAR�AI_ [9na \111 Jun. 19. 2013 10: 12AM Div of Criminal Investigation No. 7492 P. 9 ' IOWA CRIMINAL HISTORY DCI 00620515 FELONY CONVICTION PAGE 1 OF 4 DATE PRINTED- 2013/06/19 DCI:00620515 NAME: TRIMBELL,NTCHOLAS SCOTT DOB SEX RAC HOT NOT EYE HAIR SKR POB 19780713 M W 509 170 BRO PRO FAR IA • ADDITIONAL IDENTIFIERS TAT BACK TAT R LEG TAT UL ARM CCH RECORD 4" • 01 ARRESTED 20000512 ' AGENCY: IA0070100 CEDAR FALLS PD CHARGE NO- 01 IA STATUTE IA123-47(1) PROVIDING ALCOHOL TO MINOR TRIC#: 600115601 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE IA123-47-1 PROVIDING ALCOHOL TO MINORS CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 600115601 SENTENCE DISP EPP DAT FINE $250 20000912 PROBATION lY 20000912 SUSPENDED 60D 20000912 02 ARRESTED 20020723 AGENCY; IA0070100 CEDAR FALLS PD CHARGE NO- 01 IA STATUTE IA124-401-5 POSE MARIJUANA TRK#; 600841401 CHARGE NO- 02 IA STATUTE IA714-2-4 THEFT 4TH TRK#: 600841402 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE IA124.414 POSSESSION OF DRUG PARAPHERNALIA COURT CASE ID: 01071 SRCR107637 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 600841401 RESTITUTION SENTENCE DISP EFF DAT FINE $50 20021018 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 02 .IA STATUTE IA714-.2 (4) THEFT 4TH DEGREE - 1970 Jun. 19. 2013 10: 12AM Div of Criminal Investigation No. 7492 P. 10 DCI 00620515 • PAGE 2 OF 4 COURT CASE ID; 01071 SRCR107G37 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 600841402 RESTITUTION SENTENCE DISP EPF DAT SUSPENDED JAIL 30D 20021010 FINE $250 20021010 PROBATION 2Y 20021010 03 ARRESTED 20030509 AGENCY: IA0070000 BLACK HAWK CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 1ST OFFENSE TRK#: 601141201 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / 1ST OFF COURT CASE ID: 01071 OWCR114032 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 601141201 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION RESTITUTION SENTENCE DISP EFF DAT TIME SERVED 5D 20040106 SUSPENDED JAIL 115D 20040106 JAIL 120D 20040106 FINE $1000 20040106 PROBATION 2Y 20040106 04 ARRESTED 20040724 AGENCY: IA0070100 CEDAR FALLS PD CHARGE NO- 01 IA STATUTE IA124.401(5) (M) POSSESSION OF MARXJUANA • TRK#: 601629101 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(3) -2 POSSESSION CONTROLLED SUBSTANCE, MARIJUANA COURT CASE ID: 01071 SRCR124512 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 601629101 LICENSE REVOKED • SUBSTANCE ABUSE EVALUATION Jun. 19. 2013 10: 12AM Div of Criminal Investigation No. 7492 P. 11 DCT 00620515 PAGE 3 OF 4 • SENTENCE DISP EFF DAT COMMUNITY CORRECTIONS 20050110 SUSPENDED JAIL 600 20050110 FINE $250 20050110 PROBATION 2Y 20050110 IMPOSED 20061207 REVOKED 20061207 TIME SERVED SOD 20070529 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO 01ST COURT • COUNT NO- 01 IA STATUTE IA714.2(5) THEFT 5TH DEGREE - 1978 COURT CASE ID: 01071 SMCR124519 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 601629102 SENTENCE DISP EFF DAT FINE $50 20050110 05 ARRESTED 20060621 AGENCY: IA0070300 WATERLOO PD CHARGE NO- 01 IA STATUTE IA713.6(A) BURGLARY 3RD DEGREE TRIO: 602417201 COURT DISPOSITION AGENCY; IA007015J BLACK HANK CO DIST COURT COUNT NO- 01 IA STATUTE IA713.6A(1) BURGLARY 3RD DEGREE COURT CASE ID: 01071 FECR140391 CHARGE CLASS: FELONY CONVICTION TRK$: 602417201 RESTITUTION SENTENCE DISP EFF DAT COMMUNITY CORRECTIONS 20061113 FINE $750 20061113 SUSPENDED FINE $750 20061113 SUSPENDED PRISON 5Y 20061113 PROBATION 51 20061113 PRISON 51 20061113 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. fj) N. . jun. 19. 2013 10: 12AM Div of Criminal Investigation No. 7492 P. 12 DIVISION OF CRIMINAL INVESTIGATION