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Home My WebLink About13-019A r 1 .�r�—�®I VIII 11.4 CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name 2. Mailing Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) C3-Iq (Office Use Only) 3. Telephone: Home 4. Prior experience in transportation of passengers: Other: 5l9- 7 56 - 54 5�5 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? /Uc 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? A),, Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 2 1 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /t,41 TVDe 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) de .dro, dg 09/2012 I hereby ce Ty that Iqh 06, issued to me by the Iowa Department of Transportation a valid Chauffeur's license number I f i(, 7 > G�j . 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 1k 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) /I A „ 9 Signature of Applicant 4A #_1a Date 3 / *f *RR1144f#1ff#YH####H+####+##+i+*RRRk*R*tRRif4+HHf4HH1f1N##fH#H##HY##H#HHH##*4Y#f#R*##+'k*R4HR*k#*RIHk*1H11HHf1H#YHH##H## STATE OF IOWA ) COUNTY OF JOHNSON ) I 1 SuttTibed and sworn to before me by �«�v�� CA ��C�oOn this day of �Pu lic in and for the State flic in and for the State f Iowa k##H4#f4#ff#ffllfRf*#tf1R**kk**k*##kkk#****4k#fk#ffkHffRRfflf#Yffflf%f##11f#f##f#Rf##*%%k*#****#****k%*kk***kf####4kk1k#*kHHf#Hff1f;%HR*## 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). Signatuof P017 ie 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. Signat re 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 Date Ger .,driWadg.pp201 0 d 09/2012 CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX 1. Name 2. Mailing Authorization Number (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 3. Telephone: Home Other. 5/y— i 56 - 54 5- 0 4. Prior experience in transportation of passengers: r d M. Q./ V (Acw' e 2� . J 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? AIG Tvpe 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?hh_ Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? �� 2 Tvoe of offense Where When 8. Has your drivel's license or chauffeur's license been suspended or revoked in the last five years? / �C 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) IQ v=A TIGATION (DCI) REPORT AND STATE CERTIFIED HE = r -1A Y THIS APPLICATION FOR POLICE CHIEF REVIEW MICHgEL GLENN criminal Investigation Report (form available upon request) The re - 68 HOLIDAYLOD NORTH LIBERTY, A 523D 7,tuest and needs to be reviewed by the Police Chief with this appli- DLNo. 155AC4503 Iss Oq/13/2012 aas.D exa 03/06 16 UIRED SIGNATURE AND NOTARY) RestrictEions3 •y"r• /Zp 4) s l.sx DOB 03/06/1968 c +, Dd,- GRY DD 659212498 ®� ORv 09/2012 vee. to. [v l[ 7.v'inm ,vlv o bt.lit r,d. :11veSliodI un i2 12 30:429 Yellow Cab of igwa cny ' I , 3/93382708 n °' ° v t N l r l I I 5`T,ATE Oil l O�rVA Criminal History Record Check kegnest Form ' I t To! lams D[risuul or C'r"mtinol Invcstiencion Snppart Olivruinu, Hurrau, I" Fluor 215 12. 7'" Srruat Des Moines, lu,ap 111319 (,15)72.1-6066 (515) n5-6nRo rp. DCI Ac aunt Number: 9q��-� rif urrlicaeml . Frons: LAS bre TowA C17`/ Y. (� enau:< lit 9 Prix: 31g 33b-dl�)7 I nm rcqu��sun_ me lana t. nmmul l n510 ' Last Ntnnc nnal-mprt I lccutuu L IKtiA t/,,. T Fi,st Nadu taunl,thm NLddle Name wefturentkdi , INMrcgryi<� C�e�� G (I"\ tI� Date of Birth I.DWhtanlrl Gcnder lmnnd.rvx1 Social NumberlneI ndedi Al \61> ❑FemDie (Stecurit-y UY-�� FI'n!r r hrjnnnaffnn; wilhonl a sipnul nniver rrum the suOJect of cbe request, a C901Plrle criminal history r[conl ratty not Information, or allowed bylaw, alwn)'s b[ releacablc, per Codr of lutra. (1usprcr 6923, Fur enmnlr(e criminal history rocard otdn in a waiver si •nann'[ fnm. rbe atlh• t of lh[ r ursl. iYrrn'er Relrnsr l I,eroh, ,,..• Iwm.,.znv, htl nw ,d+arr Ly„+ni�e "111,61 1..,:edva an Inn a CoMI I Whim) Mord ewes ram the oM"M of tSitu'MI tt,.ne QClulny in lclroild 01 ell,l,•ed U)' 16W :n,cA•t.Lmn IIA It AA, OIWWJ IWm11 Ln.-M.fd.ne Ipelfnitl"UlWmed lirdiver ISiwtIlium �4L —�i�-- lows Criminal History Record Check Results (OCs we Only) As ui a seurch of the: provided n9me and dale of birch revealed: n ❑ Au luwa C'rimival liisturp Record found with DIICIlInn'' 11 I f sown Criminal t{iswq• Record attached. DCI?% `� N DCI initia6 I I R... iv.A Tim. 0.r 1) ?019 WOO Na. 7994 a 9 Ve C. 10. LVII 7:V)mm V v 01 yr Iri, III :TIVCp l; SSI t0" 11 J. 00!( r. L/C IOWA CRIMINAL HISTORI DCI 00494587 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED - 2012/12/16 DCI:00494567 NAME: HOPE.MICHAEL GLENN DOB SEX RAC MGT WGT EYE HAIR SAN POB 19680306 M W 602 320 BLU BRO FAR IA ADDITIONAL IDENTIFIERS CCA RECORD •'• 01 ARREBTRD 19950207 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401-3 POSSESSION SCHEDDLB I—MARIJUANA TRRp: 014615801 COURT DISPOSITION AGENCY: IABS2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA TRRp: 014615501 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950707 PROBATION lY 19950707 COMMUNITY SERVICE 100E 19950707 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. 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 ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION CC Department of Transportation �/( Office of Driver Services (Toll Free) WO -532-1121 PO Box 9204, Des Manes, IA 503069204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/29/2013 DL/ID #: 155AC4503 (IA) Customer #: 3239199 Name: Hope, Michael Glenn Class: D ID Status: None Address: 69 HOLIDAY LODGE RD Audit #: 5921249 DL Status: VAL Issue Date: 04/13/2012 CDL Status: None City/State: NORTH LIBERTY, IA Expiration 03/06/2014 CDL Cert None 523179516 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 69 HOLIDAY LODGE RD Restrictions: Corrective Lenses Restriction None Date of Birth: 3/6/1968 Supplement: Mailing City/State: NORTH LIBERTY, IA Sex: M 523179516 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 11/01/2008 12/02/2008 S92 Speed 52 IA 06/17/2012 07/18/2012 S92 Speed 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 03/17/2012 677633 IA Name: Hope, Michael Glenn DL/ID: 155AC4503 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%'i 1/29/2013 IOWA'-*' e D. O.T.:g% 7%'•••••''•�� Office of Driver Services „flfllYtR,_= Iowa Department of Transportation Name: Hope, Michael Glenn DL/ID: 155AC4503