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Home My WebLink About13-112 Authorization Number 1`'2) ) I - 1 (Office Use Only) 4174:7-14101.-1.,1 staggliatir 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 First (� I Middle Last 1. Name Go / JOL_ I � eT 2. Mailing Address Z-5-02. B A 14-re rl 1L Apt ZA 3. Telephone: Home Other: 773J ( i 5 7z914:7 4. Prior experience in transportation of passengers: b L 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? sI eS Type of offense Where When P. 0. S C l� ��,� 0 , Vic. ( + y4S- 6. Have you be n 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? NO Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? / k) 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) No 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) clerkAaxdrivbadg 03/2013 I hereby.certify that h ye. sued to me by the Iowa Department of Transportation a valid Chauffeur's license number • /k Lv . 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 tie provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) // Signature of Applicant . � � Date 5 / U A3 STATE OF IOWA COUNTY OF JOHNSON ) cubed and s or to before me by �Bt)b h / 1 i )p . On this 0-1-h-- day of / 1 . � - l (I. (if / —E-k KELLIE K.TUTTLE Notary Public in and for the State of Iowa orrrssrOn Number 221819 i. i rmMy C.m issi. E •fres *********************************************** * * ***************************************************************************** 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). c2 0 (7/ 4*- Signature o Policzr lef 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. Sig e of City lerk 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 clerWtaxidrivbadgeapp2010.doc 03/2013 ... Iowa Department of Transportation �.#•• Office of Driver Services (Toll Free)800-532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 5/1/2013 DL/ID#: 690AI9763 (IA) Customer#: 5937812 Name: Riley, Bobby Joe Class: D ID Status: None Address: 2502 BARTELT RD APT 2A Audit#: 6909763 DL Status: VAL Issue Date: 05/01/2013 CDL Status: None City/State: IOWA CITY,IA 522462713 Expiration Date: 07/21/2018 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 2502 BARTELT RD APT 2A Restrictions: NONE Restriction None Date of Birth: 7/21/1967 Supplement: Mailing City/State: IOWA CITY,IA 522462713 Sex: M History Information CLEAR DRIVING RECORD Name: Riley, Bobby Joe DL/ID: 690AJ9763 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: �y yFlllClfpru l$t-.. ....!G�10 5/1/2013 * IOWA tr / C J SOffice of Driver Services , RBowaDepartmen`ofTransportation Name: Riley, Bobby Joe DL/ID: 690AJ9763 may tMa;'._15._ 2013 3.1 38.PN(Cab Qiv of Criminal Investigation 3192352705 No. 3298 P, 1/1 .sat . STATE OF IOWA � t lows Criminal HCheck istary Record " ?� kgs )>p ; fL Request Form DCI Account Number: 9967-F (If applicable} To: Iowa Division of Criminal Investigation From: Yellow Cab of Iowa City Support OpetationsBureau,V'Floor F.O.Box 428 215 8. 7t"Street DesMolnes,Iowa 50319 lova City,EL 52244 (515)1256866 (515)72S-6080_ Fes (319)338-9777 Phone: Fax: (319)339-7302 I ant requesting an Iowa Criminal History Record Check on; Last Name(nendetery) First Name(manaemty) : Middle Name(acommendo. • kl I I el nobby as e_, Date of Birth(mandatary) Gender„__ (�mmareuory) • Social Security Number(recommmdcd)) J u L 7 Z( ( f I{;(a� IlaiC-Eale ❑Female 3% ` Co' Z ” 75-0 Waiver.Thformation:Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history•record information,as allowed by taw,always _obtain a waiver signature thorn the subject of the request. • • Waiver lelease;t hacby give permission roe the above rcqutshtgoniciel to conduct an Iowa criminal history record theckwith the Dlvhion of Criminal Invcadtarion(DCI). Any criminal history darn crmccming mc that is mainlined by thv DCC may be release)as allowed by Ia. { Waiver Signature: de /4I f L!/��✓f • Iowa Criminal History Record Cheek Results (Daum only) As of 5 k$ ,a search of the provided name and date of birth revealed; . • No Idwa Criminal ilistory Record'found with DCI 0 Iowa Criminal History Record attached,DCI# DCI initials k' • • • ACI-77(08/25/10) Received Time May. 7. 2013 3r59PM No. 2390