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Home My WebLink About13-0631. Name dIaIaLX0.1V,a h vvsia IIq- XAh4i(- 1\1� 2. Mailing Address 24 24 CZ `s :V e, Wa l t "F-) 3. Telephone: Home i% I f) Z 2 7 ? o � 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 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?64 () 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? y4 T Tvoe 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) oierkWiidnvMdg 03/2013 Authorization Number 1-3-63 (Office Use Only) CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington street between 8 a.m. to 3 p.m., Monday— Friday.) Iowa City, Iowa S2240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name dIaIaLX0.1V,a h vvsia IIq- XAh4i(- 1\1� 2. Mailing Address 24 24 CZ `s :V e, Wa l t "F-) 3. Telephone: Home i% I f) Z 2 7 ? o � 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 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?64 () 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? y4 T Tvoe 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) oierkWiidnvMdg 03/2013 I hereb(y, certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license numbe L4 1`�F 2� � 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 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 Applicant �� Date 72 STATE OF IOWA ) COUNTY OF JOHNSON ) MSubscribed and sworn to before me byq\�\�,�Y.�_'�h,�o\\_�� On this l3� day of �ta� blic in and fo the Stat f Iowa -7(31(`1` 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 Signa re of Pore hie 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. ?� e�J Signa 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 den idriwadga pp2010 da 03/2013 PA,��r.11. 2013 2:42PM Div of Criminal Investigation 1...... J. ..v,/ IL,V,,III �,., ..... i„ ., v,..i I.— v, NNo, 6838 PP. G1/1 8VAT-9 OF IOWA (bdMbH1.Mgto_ty Record Check Request Form ACI t+,,acountDlumher; ��a �� ' Qfepplfea6lo} To, Xw Y1(vis(on OcWMI1101.1XV63irgatfoh J")1111 CITY a TOVA 01 Support opatallb'lNoegAtt,111)nabr CT17C Cl;='S OEDTC nXSU1'11havaeE - 41n 1x. ,xAs�g To1a'srx3rr basr M911[% Yowl 50319 (9zsyvy.dsdd 2019A CTTY TWA 5224q (g1� 72Q-6080 p'aY: , khonA; 479-95F-.5(141 VAX! ^219-34(.--5497 , R ble I 1 a—ta—I L:LcG(Y1 o ti_ 7 jam-aie 1lvoinaYe _ o � 6 r; �YasV� ��forYnntiail; Wifhautnslgaedpi'AYoYilom.11tosub3cotoftheregnla�) q Nlnp teoh%9indlhisfory teeord)neynot bayde"llble, aeYCoda o£xoprp, WFAV;., olanvv 1 Wahle?-ke/Mre'.IhurchyANapes(nlcs(d11torIhan6ovanqu6Mrag 011%141/o sonevo[ nu lowq cdmInAI AIsWtywofdths 41vii1h 2oDAiston0fcr lnoI %nYas(1aa11on(UCp. �� Wya/mMepdsrolydalgconoomhTd.G(((� /gre�ofiatlmolnpm(ned4y1hop01mpyBoYelcesOdavPlfoNad6ylnly. 13�rr1`Ye1 SYgNat�rle; c 1 7Iowa �rSmfna3k��or�'�eeoxc� ��teoY��eauiYt� , (�elw<a16�: AE; ff__ ,1tse0roh, of the j)l'ovid'ed nama Phd AftI Of h1h.xeveale d,' u1 11Ior67vaGS.•lminal�istoxykecord>?oundwatlxbCZ _ •-�1 � �'•.� • ® x0'OPHL%lmfria��-ile40f',y�eGOYdstl&ailec�,DCY# 1~ M1' I7CYWflala t Received Time—Mar, 5.--2013=12;04PM—N'o, 53((2'3 111:1.:/•/ IIINI'ih/ llll I r Iowa Department of Transportation I�a 3 Office of Driver Services (Toll Free) BD6-532-1121 PO Box 9204, Des Moines, lA 503911-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 3/12/2013 DL/ID #: 459AF2353 (IA) Customer #: 5741899 Name: Abdalla, Jalaleldln Class: D ID Status: None Rahemtalla Address: 2525 BARTELT RD APT Audit #: 5811391 DL Status: VAL 2A Issue Date: 02/21/2012 CDL Status: None City/State: IOWA CITY, IA Expiration 04/25/2015 CDL Cert None 522462718 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 2525 BARTELT RD APT Restrictions: NONE Restriction None 2A Date of Birth: 4/25/1974 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522462718 History Information CLEAR DRIVING RECORD Name: Abdalla, Jalaleldln Rahemtalla DL/ID: 459AF2353 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 wltness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: •y;`/84� 3/12/2013 IOWA ).O.T.iWy . S' P •••••. Office of Driver Services 1 88111%,== Iowa Department of Transportation Name: Abdalla, Jalaleldln Rahemtalla DL/ID: 459AF2353