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Home My WebLink About13-0295. 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? N O Tvoe of Offense Where When 14 Cec�—T�.aI�P Tf7ocC r Cto�. l o r '.' 7. Have you been convicted of any traffic offenses in the last five years? —T e S . Type of offense Where When GOA_ X0 Q) T RQt=ct tgW '1 11 t 212410 SQC<d xOw q CCTV�1111200. 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? KI O 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) "O 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) derM ,dn; dg 09/2012 Authorization Number 13—,;19 l 1 (Office Use Only) CITY IOWA CITY APPLICATION FOR TAXI DRIVER OF (Police Department review must be made 41 0 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 L U 1 C C 1-1 AV E SCo(3A R 2. Mailing Address TOW c, C1-i�U. TA 3. Telephone: Home 19 - t-1 -4 1- -)r G4 7 Other: 4. Prior experience in transportation of passengers: TAg> n dmvwe 'I 'PIN (o6S foR y Pgas- 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? N O Tvoe of Offense Where When 14 Cec�—T�.aI�P Tf7ocC r Cto�. l o r '.' 7. Have you been convicted of any traffic offenses in the last five years? —T e S . Type of offense Where When GOA_ X0 Q) T RQt=ct tgW '1 11 t 212410 SQC<d xOw q CCTV�1111200. 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? KI O 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) "O 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) derM ,dn; dg 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number SSSy t (a 3 4 . 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 IL Date 01 /1 qj 13 R****IIHHfIHH###HH#H***H*11flIHIHf 1##H#H#*#H**H****lR1HHHlf1H!#Hf#HH##*#*#*****HHIflItHIHH##H###HH**44H44f1H1HH STATE OF IOWA ) COUNTY OF JOHNSON ) S cribed and sworn to before me by Lei S k?C D On this �~ day of ',?C)) a m KELLIE K. TUTTLE - , cC." slop Nam er zzlals otary 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). Signatur of Polic ief or designee 0?-�)Ci-/ 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. -Avt� 2 X/. -kaly SignaWre 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 ,;2-- Q - t3 Date dM dnbadge pp2010.tl 09/2012 ARTS Page 1 of 1 CIowa Department of Transportation AO Office of Driver Services (Toll Free) OM -532-1121 PO Box 9204, Des Moines, 1A 50306-9264 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/30/2013 DL/ID #: 555XX6834 (IA) Customer #: 406903 Name: Chay Escobar, Luis Class: A ID Status: None 06/19/2009 Alfonso S92 Speed 16 ;IA Address: 1206 DIANA ST Audit #: 5077274 DL Status: VAL Issue Date: 03/11/2011 CDL Status: VAL City/State: IOWA CITY, IA Expiration 12/24/2015 CDL Cert None 522404629 Date: Status: Endorsements: NONE CDL Med None Status: Mailing Address: 1206 DIANA ST Restrictions: NONE Restriction None Date of Birth: 12/24/1963 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522404629 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 11/08/2008 12/16/2008 S92 ! ;Sppee ed j10 mph &under in 35-55 mph zone) 52 ,IA 06/19/2009 07/29/2009 _ S92 Speed 16 ;IA 11/18/2010 :12/09/2010 _M14 Fail to Obey Traffic Sign/Signal 52 'IA Name: Chay Escobar, Luis Alfonso DL/ID: 555XX6834 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 1/30/2013 IOWA �l�r ). 0. T.� s -�� f,{(�,y!qrq'�'J! 1�.11�� '�J �'�'' A r ......- Office of Driver Services aDfilay„ Iowa Department of Transportation Name: Chay Escobar, Luis Alfonso DL/ID: 555XX6834 http://172.29.254.55/drivers/reports/eustomerhistoryleertifieddrivingrecord.aspx 1/30/2013 F..20i311;1Divy of nve1Ol11Jeit1i1,3311tK—Utyo1Wa1,Y A�Ilil'/A/• v jSrVAx'] 0.V IOWA tw ininalMstoxyReco>rd Check RegttegtForm n To. 101YA bblalon orCruinal x4vaAgatfon Support opoeatlona Rul'oau,1'f $Iaor .my.w. 'I,,Mrw ,� bel+r in W, IOWA 50519 (ens) 73X dw (315) 119-000 11A T AM requWNX an ToM Criminal SiOM Record Chea(( on; No. 1810 P. 1/5 No, JID/ Y. (/I nl>''bf/fa s i V AjPINn� j �. _ ACT2�ocovnCNumber; �W�" ppp/rqb o Fran_ir 77 of TowA �::rxp GM am"a 03=0A 0 TOM r7Tr TOwA 449 , Pl'tan8: ' a're�asfz 51101 ,.,� 1711X! 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