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Home My WebLink About13-0446. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ria Tvpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? t.» Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? WO Tvpe 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) cleh .Idrivbadg 09/2012 / 3 — 4� Authorization Number r 1 (Office Use Only) -4 ECEPIII 4h + M0®iciii 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 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX First Middle Last 1. Name yl; Icon. A- 2. Mailing Address %IL: W ()kva�& Ss, i3�1 3. Telephone: Home 31(l 7533 („clS Ln Other: 4. Prior experience in transportation of passengers: N 'A- Pr5. 5.Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? eSSce 6et� Tvpe of offense Where When Curti'4, lie Z -/F iO�Zy Ityhy 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ria Tvpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? t.» Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? WO Tvpe 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) cleh .Idrivbadg 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeurs license number {g08 � , 6Cc31 . 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 1%IfNK) Date STATE OF IOWA ) COUNTY OF JOHNSON ) /� l ' S bsenbed and sworn to before _me by hl/ ' `11 /�" On this day of �G Zo fLC jL� fzc Notary Public in and for the State of Iowa My 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). Signatur of Police Chief or designee gz?6 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. Signatu 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 a-meg-�3 Date derMl idrivbadgeapp2010.do 09/2012 s Iowa Department of Transportation Office of Driver Services (Toff Free) 800-532-1121 PO Box 9204, Des Moines, fA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 2/27/2013 . DL/ID #: 608YY6801(IA) Customer #: 2110531 Name: Kalm, Nikita Andrei Class: D ID Status: None Address: 716 N DUBUQUE ST APT Audit #: 6667171 DL Status: VAL B4 Issue Date: 02/05/2013 CDL Status: None City/State: IOWA CITY, IA 52240 Expiration 11/18/2018 CDL Cert None Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 716 N DUBUQUE ST APT Restrictions: Corrective Lenses Restriction None B4 Date of Birth: 11/18/1973 Supplement: Mailing City/State: IOWA CITY, IA 52240 Sex: M History Information CLEAR DRIVING RECORD Name: Kaim, Nikita Andrei DL/ID: 608YY6801 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: Name: Kaim, Nikita Andrei DL/ID: 608YY6801 '•7�7%8�p 2/27/2013 IOWA; Ir ). 0. T..f�' : a �•....... S. Office of Driver Services fillI Iowa Department of Transportation Feb.21. 2013 3:12PM Div of Criminal Investigation No,4140 P. 1/5 Feo. 12. 2013 2:42PM City Clerk — City of Iowa City No. 3218 P. 3 0 4.2!•• V h hili\�} n T'o; rowAAlytaloiorWmInalXhvavtfgAtfoh support OperatCOns 13uYeAR,1'P $focr 213Jr, 0'°'S(Yeet b"X0K 4es,l'oiva 50319 (51s) vd- op'd (318) 125-6080 Iran , 1 V (W I s 1 \ r • 3 17Cit1oconntNiim6er: �� ` F Q upplPceD e) .t�•OM! f:Imv' n TOAA .T�V'V' CITY C_S} V q OOA31cl� Ain T_ WAAAI=OW SM2,V x91T4 fa`TTP TOA 53340 l hon61 119-356-041 VAX1 V9 -g56 -5[x Y -lis- —73 I PM•ule ' [()+'e IA 1, 40'_CA--7,33 13�ndveFYnfoPfispf/oblyr3fhoutaafjned pMIYOJfiamthe! su6fedol.the rggnmv, a tompkta QYffn6)A1VSfo1'y YecorgMY3tot kDbYoleg9ubfe,pePCodoaCXo'Wa,Chapter69Z.3,T�orcosn Iat bPiminalhletoxyrccor�ilnCokfnailoh,gsaU4WPdDa*19\w,nfvrny'g oAtain--waftal'8t IIaWYOA' Phosub eotoitheke ost.— -- ——' ' --- 'a YEi' 1Z916(lfBf fAcrobyA(Vo prrrofssfaR (L[$oahoy6,agoazltng0AloiAl Io conAvollatYoxa oumfneldh(ory(eao(dcf eo1 y(N IkoDtistnn gPCominal 1'nroslt@sifoa(p4p. 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A_ I. .I.A11-11 /1M1N. 8 Ncloro uly) Feb.21. 2013 3:12PM Div of Criminal Investigation No.4140 P. 2/5 DCI!00441486 NAME: KAIM,DAN KAIM,DANIEL P KAIM,NIKITA ANDREI DOB SEX RAC 19731118 M W ADDITIONAL IDENTIFIERS TAT LF ARM 01 ARRESTED 19991024 IOWA CRIMINAL HISTORY NON CONVICTION HGT WGT 507 201 CCH RECORD *** DCI 00441406 PAGE 1 OF 1 DATE PRINTED - 2013/02/21 EYE HAIR Sm POB DLV SRO FAR FL AGENCY: IAQ520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA706-1/236-2 DOMESTIC ASSAULT W/INJURY TRK#: 035763401 COURT DISPOSITION ' AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708.2A(2)(B) DOMESTIC ABUSE ASSAULT WITHOUT INTSNT CAUSING PHAROE CLASS: NON CONVICTION TRK#: 035763401 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20000216 COURT COSTS 20000218 PROBATION 1Y 20000218 DISCHARGED FROM 20000918 DEFERRED JUDGEMENT AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF QUILT. 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 A.BSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED Od INFORMATION FURNISHED, WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION