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Home My WebLink About13-058First Middle Last 1. Name-14^1eG5 5.4.? L"6 Z__ P42SosI3 2. Mailing Address P/ S • '?Lek /4V E /4,4✓4 G/ 7-K 14 SA2'/4 3. Telephone: Home 319-ry/-5/27 Other: 4. Prior experience in transportation of passengers: "� Y6R R.s 9K/Y/Nc, i 4K f 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When Al k -D 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?/%1O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? rrs Type of offense Where When Sie61016- I -8o(= 1AIT l0/3//6 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /lam 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) The re- port will be mailed to the individual making the request and needs to be reviewed by the Police Chief with this appli- cation. (OVER FOR REQUIRED SIGNATURE AND NOTARY) derbtaAmbadg 09/2012 15— Authorization Number, -5y l 1 (Office Use Only) Z.r'lll� CITY IOWA CITY APPLICATION FOR TAXI DRIVER OF (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 (3 19) 356-5040 (319) 356-5497 FAX First Middle Last 1. Name-14^1eG5 5.4.? L"6 Z__ P42SosI3 2. Mailing Address P/ S • '?Lek /4V E /4,4✓4 G/ 7-K 14 SA2'/4 3. Telephone: Home 319-ry/-5/27 Other: 4. Prior experience in transportation of passengers: "� Y6R R.s 9K/Y/Nc, i 4K f 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When Al k -D 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?/%1O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? rrs Type of offense Where When Sie61016- I -8o(= 1AIT l0/3//6 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /lam 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) The re- port will be mailed to the individual making the request and needs to be reviewed by the Police Chief with this appli- cation. (OVER FOR REQUIRED SIGNATURE AND NOTARY) derbtaAmbadg 09/2012 Z I her t1yycee t that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number S . 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 3/113 STATE OF IOWA ) COUNTY OF JOHNSON ) �, I gibed nd om j� before me by IC�.tY�2sR T s( On this 25� ' day of L � J KELLIE K. TUTTLE � `-'�"�-e- � &t4 ( 0 P0 afk r mmimon Number 221Big 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 or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). SirttTre ofrybeMief r 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. Z' Signature of City Clerk or designee Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update �- 8�-/3 Date deddlaxlddvbadgeappM1O.doc 09/2012 Page 1 of I Iowa Department of Transportation AO Office of Driver Services (Toil Free) 800-532-1121 PO Box 9204, Des Moines, IA 50305-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 3/8/2013 DL/ID #: 434ZZ0578 (IA) Customer #: 4732685 Name: Parsons, James Samuel Class: D ID Status: None Address: 801 S 7TH AVE Audit #: 6719710 DL Status: VAL Issue Date: 02/23/2013 CDL Status: None City/State: IOWA CITY, IA Expiration 02/12/2018 CDL Cert None 522406205 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 801 S 7TH AVE Restrictions: Corrective Lenses Restriction None Date of Birth: 2/12/1981 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522406205 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 10/06/2008 10/31/2008 S92 Speed 52 IA Name: Parsons, James Samuel DL/ID: 434ZZ0578 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: ••';v/''4 3/8/2013 IOWA'*° c�v Office of Driver Services Iowa Department of Transportation Name: Parsons, James Samuel DL/ID: 434ZZ0578 http:// 172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 3/8/2013 L Feb.26. 2013 4:41PM 02/26/2011 10;04 PAX 19 Div of Criminal Investigation No. 4675 P. 1/1 a DCI IOWA . Q002 STATE OF IOWA Criminal Metory Record -Check Request Form Tot lam 11hriefnwefCtinladlayoMption Rapport Opmdoar f ran, a Floor 915 R Te 6tnet DoMelawtown 3019 (515) ="W (013)12"Do FAX DC1Aeoaunt Number:38 ( rpe bo) Fro.t ,�Vl.rcee T� (LI Pilo": Ihat I am Flaunfint as Iowa t YtmOW rileto xmom(: euc on; lad Name First Na Midd arae � f'f(1Zsr-� Jf}N(G S sANilll° Data Of Btrtb mueta) Gender social Security Number �2/ I Z-/� ®Mak OFenafo S� - l $ • $ I.2q Waiver /gforM(j&n: Wl*wt a dpd wabw froze at obled of the rcgaraq a Complete Mutbd blelory record may not bo tdnuble, Dar Code orlowa, G'iapler6%A For wmpkn ettCeWl blrtery•rseord Infermanow, m allowed by lows elm" obtain a walver dzutuft 610 the wh Cor of lie art, waiter Reease.. eM th'r t+� MUr etewrgeraasa dlkieimm IawwwbeYelrJ�ry,mrb meawW d.IX.LleaoJCdnbal barattwlenMM AeYauaolentrrd.rcawove t Mdatl, rlhradby nt&eeuaaowcdbyiar. waiver signuarl. (W osa,ly) As of �O1NUN 13 a search of the prov[dod amt; and dato of birth rawakd: No Iowa CombW History Record found with DCI -� ❑ Iowa Crimbud History Record attachod, DCl b DCI lnitlals x[ar(asns[io) '�