The URL can be used to link to this page

Home My WebLink About13-057. I r , 0. —®4 �►. MIIr®r�� CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 3S6-5497 FAX Authorization Number /-";3! 57 APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday – Friday.) First Middle Last 1. Name )q SV' Y,IL %c l<f 2. Mailing Address 10 1q rJ sem „ ;� J + ), , � C � y I � S Zz f s' 3. Telephone: Home (3 I (i) cj 3 6 - ZS 5 h Other: 4. Prior experience in transportation of passengers: N 10 jr d, (Office Use Only) yell>. L410 # Mn/Cod -4Xr 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When NSI LI-" 5—+1, dee re[ 1'1.-e. L, `-Ic/C✓e�r„/ 4ca.i t"_" C j? Zoo E 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? N= Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? ye S Type of offense Where / When 12 ;Z q 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? No 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) /`/0 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) deMmidrivbadg 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number sg Ir: . 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 Date S/7/13 4+###44#*RR**RRYR**###i+#4###*YYYYYfHYY###*R**fr*#flfflffNffYYY##Y#*#*#Y*#*#f*lffR*fffYffRfYYff41f##Y**#*NR**!RR*fR*iflflMf###4****RRRRRR*fRR STATE OF IOWA COUNTY OF JOHNSON StrH Ia ,ed /n� swo,p tol �fore me by ) 0 y A L LS On this 74� day of 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). gnatun of Police Chief or designee 5111113 T 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. Signature of City Clerk or des�ignee Taxi cab businesses are required to provide Driver Identification cards. -5-7-1,5 Date xx*#Y+#++####x#xx#xxxx*xYY**#++#+#x*xx**xx**x*YxxY**+####*xxx*xxx*xxx*xxfxx*xxRYRYR****+#*#*++#+##+x#*Rx**xRx**xx*Yx******#Y###Y*#**xx*#xYY#xx*# Office Use Only Approved application DCI report State certified driving record Website update danma,adivbadgmpp2010.d 09/2012 CA Iowa Department of Transportation Office of Driver Services (Toll Free) SM -532-1121 PO Box 9204, Des Moines, 9A 503W -92G4 515-244-9724 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 3/7/2013 DL/ID #: 290jj5816 (IA) Customer #: 3968765 Name: Hicks, Jason Yale Class: D ID Status: None Address: 1017 N SUMMIT ST Audit #: 5454242 DL Status: VAL 10/24/2010 12/07/2010 Issue Date: 08/18/2011 CDL Status: None City/State: IOWA CITY, IA Expiration 07/19/2016 CDL Cert None 10/15/2011 522455938 Date: Speed Status: IA Endorsements: 3 CDL Med None Status: Mailing Address: 1017 N SUMMIT ST Restrictions: NONE Restriction None Date of Birth: 7/19/1973 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522455938 History Information Convictions Citation Date Conviction Date ACD Explanation County IUR 11/20/2008 12/09/2008 M14 Fall to Obey Traffic,Sign/Signal _ _ -52 IA 07/30/2009 08/18/2009 M14 }Fall to Obey Traffic. Sign/Signal _ ,52 9A 10/24/2010 12/07/2010 _S92 jSpeed ,52 -IA 03/26/2011 X04/27/2011 "N50 Improper Turn 52 IA 10/15/2011 01/19/2012 S92 Speed 52 IA Name: Hicks, Jason Yale DL/ID: 290JJ5816 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: :.......:wj�y� 3/7/2013 IOWA D. 0. T..:& ` 'c S> 7f ""'..5�==- �—� Office of Driver Services ,I Da Iowa Department of Transportation Name: Hicks, Jason Yale OL/ID: 290JJ5816 o2.F eb: 2j-- 1_;25AM D Div of Criminal Investigation No.4066 a DCI IM STATE OF IOWA CrirninalHistory Record Check Request Form V Tor laws D&Woporcrtnlnalyevedlgdoa 8onmrt oparsttou la 14 l" Floor 315 r:7* 8MM M"Matap,lawn M19 (515)7154W (515) 7254M Fina DCI Account Number.013 YiEk) • Wim: _ {N1arc.s Taxl �Ib $•�•Wtw• pf• Phan: O(R) 331- Fatr. • 3i9 SSI C Leall Naoffe FirstrRe ) Middl Nitrate i C. 1�? a 'an y4 I e— Ditto of13irtb SW&l3eeorl bvber 7 (� 7 3 Mutt ❑Female pi Feb.21. 2013 11:25AM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00705054 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTiD- 2013/02/21 DCX;00705054 NAME: HICRS,JASON YALE DOB SER RAC HOT WGT EYE HAIR SAN' POB 19730719 M W 510 150 HAZ BRO PA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD ♦�a 01 ARRESTED 20030826 AGENCY: IADS20200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA716-6 CRIMINAL MISCHIEF 4TH DRORSE TRK#: 100939301 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA716.6(2) CRIMINAL MISCHIEF 5TH DEGREE COURT CASE ID: 06521 SRCROG6291 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100939301 RESTITUTION SENTENCE FINE $50 02 ARRESTED 20070907 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA719.1(1)B INTARFERENCE W/OFFICIAL ACTS BODILY INJURY TRK#: 1A002AH01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA719.1(1)B INTERFERENCE W/OFFICIAL ACTS, BODILY INJURY COURT CASE ID: 06521 AGCROOD742 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: IA002AHOI SENTENCE JAIL 51) FINE $625 03 ARRESTED 20100419 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLRD SUBSTANCE TRK#: 1AD096TOI COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124. 1101 (5) POSSESSION OF A CONTROLLED SUBSTANCE DISP EFF DAT 20031021 DISP EFF DAT 20071207 20071207 No.4066 P. 2/10 Feb.21. 2013 11:25AM Div of Criminal Investigation No.4066 P. 3/10 DCI 00705554 PAGE 2 OF 2 COURT CASE ID: 06521 SRCR090556 CHARGE CLAS$: NON CONVICTION TRK#: IA0035TOI SUBSTANCE ABUSE EVALUATION DEFERRED JUDGEMENT 20100915 COURT COSTS $315 20100915 PROBATION lY 20100915 DISCHARGED FROM 20110513 DEFERRED JUDGEMENT AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAV OF IDENTIFICATION IS A PUBLIC RECORD.BUT CAN ONLY B$ RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION T IOWA 7 N SUMMIT Si !A CITY, IA 52245 pp 75464i4]]HJ1" M190716D USA IA