HomeMy WebLinkAbout13-086r""III ��ft%Zt
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CITY OF IOWA CITY
410 East Washington Street
Iowa City, Iowa 52240-1826
(3 19) 356-5040
(319) 356-5497 FAX
Authorization Number
APPLICATION FOR TAXI DRIVER
(Police Department review must be made
between 8 a.m. to 3 p.m., Monday — Friday.)
First 1\\N
1. Name �105t0� C r UL
2. Mailing Address 15o b 50d u et S4
3. Telephone: Home 30- S{ kW
4. P ''or experience in transportation of passen1ger's:t UCtf t
✓` rY'(y
oar C4 IA- Sdd`f o
Other: /r
raI 1�<w6 Sir ai )��rUZ
5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere?
Type of offense n/ Where
5,61 .G rk(. , NCcDWJ,.T— AAJ,&h ' l eor_CL
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r
(Office Use Only)
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6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five
years? N 0
Tvpe of Offense Where When
7. Have you been convicted of any traffic offenses in the last five years?
Type of offense Where
51j—, L ,
When
7 -(Y -o
8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ! D
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)
N00
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)
deVaxidnvbadq 03/2013
I hereby certifv that I h ve issued to me by the Iowa Department of Transportation a valid Chauffeur's license number.
3 - � . 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 a d all records and documents relating to this application, and I further agree that, if a license
is granted, to comply at all ti"s'th all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front
of a Notary Public) -y
Signature of Applicant 2� \Z,�— Date Ae I ( 5 ( :)'0(3
#f###Y##**********fHH1f1HHNflHH#f, k}S#M*ffi##4Hff f ffHfffffHHfHfH4HY#1H*#R*#*!**f*Hftffff fffH4HfHHHYH}}H#*H*}H**1flfHff
STATE OF IOWA )
COUNTY OF JOHNSON )
Subscribed and sworn to before me by Z o
-�^ �- ��� � "�. On this
Iowa
day of
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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 resi ents of the City of Iowa City (Title 5, Chapter 2, City Code).
tignature of Police Chief or designee
1.3
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.
%91a.>%Alln-l-L ye - waft/
Sign tore of City Clerk or designee
Date
Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/:" (width) and 5 Yd'
(height) and prominently displayed to all passengers.
Office Use Only
Approved application
DCI report
State certified driving record
Website update
d#d,aa idriw dy aWMiod 03/2013
,31Mar_ 13. 2013 5 5A
Div of Criminal Investigation a DCI l0RNo.7063 P. 2/3 _
STATE OF IOWA
Criminal History Record Check
Request Form
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To: Iowa DM490 of Craatn11 lavextWdon
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Des Holmes,iawa 50719
(515) 72"M
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Waiver lnforalallan: Without aApedwiwerh0mtassubjectorthenitaaat,aeomplt Obvious) history record May not
record leforadob, W oUowed bylaw, Always
he releasable, par Cods erlown, Chapter 6921, For AUsa ftct mizal hblory n
r
obtain a aper lizaahwis from lbs sub ed of the rogowl,
WalverRekase,ib wtiewndmianlbraarogtwil oI1lcWmmndaaantoyaauas.elYtnoryrccopdrtwAirblrYlaoorGrimnel
1nvotlpden(M). Any wiadad hlaureao, eeargelnr bY 71 vayba,alw.l u aeowd by 4N.
WalswrSignarare!
As of 5L-/,:7)— /3 a search of the provided name and dote of birth revealed:
❑( No Iowa Crllntnal History Record fbund wlth DCl
/GJ Iowa Cominal history Record aga0acheed',1CI DN r/
DC1 initial& GL__.
Received Time Mar, 1, 2013 11:00AM No. 6515
Mar.13. 2013 11:55AM Div of Criminal Investigation No.1063 P. 3/3
DCI:00783918
NAME: FRBNCH,JOE
FRBNCR,JOSEPH DEAN
DOB SEX RAC
19790515 M W
ADDITIONAL IDENTIFIERS
TAT BACK
TAT L CALF
TAT R CALF
TAT RF ARM
TAT UL ARM
TAT UR ARM
01 ARRESTED 30060825
IOWA CRIMINAL HISTORY
NOW CONVICTION
DCI 00783918
PAGE 1 OF 1
DATE PRINTED -
2013/03/13
HOT WOT EYE HAIR SKN
600 230 BLU BRO FAR
PHOTO AVAILABLE: Y
CCH RECORD ***
POB
iA
AGENCY: IA0520200 IOWA,CITY PD
CHARGE NO- 01 IA STATUTE IA124-401-1D
PROHIBITED ACTS/INTENT/DELIVER/ MARIJUANA
TRK#: 101950801
COURT DISPOSITION
AGENCY: IA052015J JOHNSON CO DIST COURT
COUNT NO- 01 IA STATUTE IA124.410
CONTROLLED SUBSTANCE/DELIVRR/ACCONMODATION/MARIJUANA
COURT CASE ID: 06521 PECRO76942
CHARGE CLASS: NON CONVICTION
TRK#: 1D1950801
SENTENCE DISP EFF DAT
DEFERRED JUDGEMENT 20061207
PROBATION 1M 20061207
DISCHARGED FROM 20070803
DEFERRED JUDGEMENT
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
0
Iowa Department of Transportation
Office of Driver Services (Toll Free) 800-532-1121
%W0 PO Box 9204, Des Moines, IA 50306-9204 515-244-9124
FAX 515-239-1837
Certified Abstract of Driving Record
Inquiry Data:
4/9/2013
DL/ID rf:
434ZZ0188 (IA)
Customer 7r:
2286220
Name:
French, Joseph Dean
Class:
D
ID Status:
None
Address:
1506 SPRUCE ST
Audit 7F:
3296027
DL Status:
VAL
05/23/2011
06/20/2011
Issue Date:
05/12/2009
CDL Status:
None
City/State:
IOWA CITY, IA
Expiration
05/15/2013
COL Cert
None
522406030
Date:
Status:
Endorsements:
3L
CDL Med
None
Status:
Mailing Address:
1506 SPRUCE ST
Restrictions:
NONE
Restriction
None
Date of Birth:
5/15/1979
Supplement:
Mailing City/State: IOWA CITY, IA
Sex:
M
522406030
History Information
Convictions
Citation Date
Conviction Date
ACD
Explanation
County
JUR
09/26/2008
10/31/2008
B51
No Driver's License
52
IA
06/07/2009
07/14/2009
S92
Speed
52
IA
05/23/2011
06/20/2011
592
Speed
52
IA
Name: French, Joseph Dean DL/ID: 434220188
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:
......
4/9/2013
ff'
Office of Driver Services
Iowa Department of Transportation
Name: French, Joseph Dean DL/ID: 434ZZ0188