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Home My WebLink About13-125 Authorization Number /3 -!d � r (Office Use Only) Me CO IOW I 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) 356-5040 (319) 356-5497 FAX i Irst Mi le Last 1. Name r%i� �' {� s�n�0,J•( �ef 536" .12 2. Mailing Address 10-1 Gi c-,o`14 40c 11 3. Telephone: Home Other: 3/9 ' $3D —'717 413 4. Prior experience in transportation of passengers: c30 7ics k/tow aex{, 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? d 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? y7 v Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? "f 1 Tf Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? "VB--- 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) —7/7 13� 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) clerknaxidrivbadg 03/2013 I e y_c that have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number U &Z / / . 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 ti es 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 - �3 STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by / 1z�,� l�f rs 2; . On this (a day of 41 r( / ks SO AE FORT Commission Number 159791 My Commission Expires Notary Public in and for the State of Iowa -A/7/0;7./(-5' +*************************************************************************************************************************************,r********* 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). i -*/ 74 Sign`ur- of Polic 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. 2/ Signat 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 Yz" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update GerWtaxidrivbadgeapp2010.doe 03/2013 ,May. 2013 2:58PM Div of Criminal Investigation No. 5082 P. 1/1 May ‘•-r:wM 6n yr Cab 'Jr mew'. .,,.y 3143382708 1-1.4 • STAYS, OF IOWA t' •„,.,4 • rt-train-?. Criminal History Record Check * :- 1,4 Request Form 47,-, ` • DCI Account Number: 9967-F or applicable) To: Iorrn Division or Criminal Investigation From: Yellow Cab of Iowa City Support Operations Bureau,is'Floor P,o.Box 428 215 E.7th Sireet Bea iVloines Iowa F0319 • Iowa Cify,TA. 52244 (515)725-6066 (515)125-6M Far (319)3389777 Phone: • Fax: (319)339-7302 1 am requesting an Iowa Criminal Histo Record Cheek_on: • _ Last Name (mandatory) First Name(frame) Middle Name irscmmmcnM) A Igt5(D6 -1 idad d wQ ,OpotA061 •Dafto[Birth(mentlnaty) I`serider(mandatwy) Social Security Number.(mcommanded) t )' C_1 �MMale ['Female waiver information:without n"signed*giver From the sublect orthe request,a complete criminal history record may not be roleasable,pet Code of Iowa,Chapter 6922.For tomtleteerlminal history record information,as allowed by law,always • obtain a waiver signature from the sobject of the regtlesf. Waiver'Release:I hereby gke r^amirsiou far the above requesting crucial io conduct an Iowa criminat history mord chock with the Division el-criminal 1n,c,-rigaden(DCI). any criminal history Oita tante g 7m cd by the DCl rosy be releasca as snowed by low. Waiver Signature: JJ •- Iowa Criminal History Record Cheek Results (DM,ecunly) As of & Zq-I+3 , a search of the provided name and date otbirth revealed: • El No Iowa Criminal History Record found with DCI 0 Iowa Criminal Ilistory Ctecord attached,DCI Ii DCI initials b&. DC1-77(OE) 5/1O) Received Time Mar. 23. 2013 4:91PM No. 4179 fIowa Department of Transportation Office of Driver Services (Toll Free)800-532-1121 III/ PO Box 9204,Des Moines, IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 6/6/2013 DL/ID #: 960ZZ6211 (IA) Customer#: 1024572 Name: Dresden, Arthur Anthony Jr Class: D ID Status: None Address: 4219 Lloyd Avenue Se Audit#: 2875102 DL Status: VAL Issue Date: 12/31/2008 CDL Status: None City/State: Iowa City, IA 52240 Expiration Date: 12/11/2013 CDL Cert Status: None Endorsements: 2L CDL Med Status: None Mailing Address: 4219 Lloyd Avenue Se Restrictions: Corrective Lenses Restriction None Date of Birth: 12/11/1954 Supplement: Mailing City/State: Iowa City, IA 52240 Sex: M History Information CLEAR DRIVING RECORD Name: Dresden,Arthur Anthony Jr DL/ID:960ZZ6211 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: 1NCi `"f0t '7,... p4 6/6/2013 '+: IOWA 0,f gff r . ,,,,e..':„%. '''o... . D9IIIEA S�. Office of Driver Services ��...--- Iowa Department of Transportation Name: Dresden,Arthur Anthony Jr DL/ID: 960ZZ6211