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Home My WebLink About13-012Authorization Number — 12, (Office Use Only) �r"III + . .0 CITY OF IOWA CITY 410 East Washington Street 52240-1826 -(319) 356,504 1 17 G_— (319) 356-5497 FAX 1. Name 2. Mailing Address _10';i I b C ( APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 3. Telephone: Home 319- �I i-a.�r��3 n Other: 4. Prior experience in transportation of passengers: `� A P(' A j3 tr Last ., C 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When A,CUKLV4_4y 6. Have you b2en convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?�_ Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? te.t 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? I V (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) ND When DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFI DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR ICE 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) GerW.&.i badg 09/2012 I herebyy� certi that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number D`t) 3 q 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 1 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 I YY44}Yf}}4}4}YR}#HRRHR#RR#Hfffffff#ffHHHHHHNf11ffH#Hf1fHHH#HHf#YiY}4#H4####}HH}Y kfff##f#11HRf1RR}RRRRfHlfflfH#HYH4#44#} STATE OF IOWA COUNTY OF JOHNSON Sub ribed and sworn to before me by t r l t Cka ej W1 I l I Cc ✓vtS . L �Lo I� a„ r ary Public in and for the State of Iowa f'> z° Commission Number221a19 My Cominissioq Expires On this l 2 " — day of 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). Signature of Police CAief or designee /F- 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. Signatur City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. *####Hi##**#*R*R*}#NR***RR#*RRfiRRNffRN*ihifiR*Nf*ififfiii*ffffff*ffRllffffN*N*fRRfRRRR**R*RR*RR***#**RRRRRRRf*IfRRRIflfRffifNfffffflRff Office Use Only Approved application DCI report State certified driving record Website update den mm adw W2=i 09/2012 Jan.]]. 2013. 4:26NM Div of Criminal investi;atlon Jan.11. 2013 9:47AM City Clerk - City of Iowa City -A.s IVo. uzdy Y. o/Y No, 3130 P. 2 0 '� 5r' �C�irnlnm �-JHfa�l<o�ryrRecolyd Check . pCIAcooUnPldllmber: �o�—F • � (Ifap�lfrnb o} 1'0: 101Ya111vlAlo'd orci4minalYa/fiOlgntloh k7mnr glrv- or -royA am SapporCOporsllorrsAurmir,l'fkloor, CIT% CLux7'q ORRIC13 21SE-5Err�n� taas�raaF•r -MSMp14G7,IolYn 50319 ' (81s) 72g•dw 100A OLTT TORA 5224Q (818) 929-dOtlO Irnx . Phoee• gin�a�,ti-5olay �y I?nxl 319 956-5�a47 — — m ragpostmg oaIowa Criminal Iiis[o RCcord Cheolc on; astl�tsme (mnndafor bYraCplarae andafan• NI(ddlolVame reoommenGe Ito AMA A mandem amdoT f�mandalao .SOan] SealrritgNls)ddr rcconmcnded 1 � i•d �� 65 W�VI'aTe ' Cflaema)'o �,3 l� 6a 3�3u �iYeF yy`ormaila7l:WLfhoutaslgnedl+v9itioril•onilhaspbieeloflfroyegneaN,ocomp]efecpf[gCnpTfilsloryreeord�nal��loC_ elea9ubTa, per Code aPraysp, ChaptcrG92,3.]rorpleta'arLmloalhiatoryrecoYdlnmrmatloly, a yalTowod)Sylgyir p({yuyy _.._ fo eondua[ento�ygodminalhts[orytecardchw$w�mJhen�isron otcrmfnel t tl<o T}pim a y{% [cJcpipd pg affolYCQ dy as Ogrofidthoprovided rpama find date o bfltha'avealed: I' EJ iMOXbwaWithACX xorra G4lminal Tiistpry ReCoI'd attac�'hi'ed�,�CT# 3 6 y DCZ�alitlals i'c� ZeceivedTmeI'Jan, 11. 9.0 13 9:47AM No. 9064 Jan.17. 2013 4:26PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00366634 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED - 2013/01/17 DC1100366634 NAME: WILLIAMS,MICHAEL JOSEPH DOB SEX RAC HOT WGT EYE HAIR SKN POB 19651218 M S 602 170 BRO BLK BLK IL ADDITIONAL IDENTIFIERS Sc ABDOM SC L KNEE CCH RECORD +';* 01 ARRESTED 1980920 _ AGENCY:. `t.520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2 ASSAULT TRK#: L32961901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA703-2 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32901901 SENTENCE DISP EFF DAT PLEAD GUILTY 19870920 FINE $75 19870920 COURT COSTS $20 19870920 0514 02 ARRESTEDj1(1=5'20200 AGENCY: IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321-210-A DRIVING UNDER SUSPEND TRK#: L329B2001 CHARGE NO- 02 IA STATUTE IA321-210 DRIVING UNDER SUSPEND TRK#: L32982002 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-210-A DRIVE UNDER SUSPEND CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32982001 SENTENCE DISP EFF DAT PLEAD GUILTY 19890515 FINE $25 19890515 COURT COSTS $10 1989DS15 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA321-210 DRIVE UNDER SUSPEND CHARGE CLASS: MISDEMEANOR CONVICTION No.0289 P. 7/9 Jan.11. 2013 4:26PM Div of Criminal Investigation TRK#: L32982002 SENTENCE PLEAD GUILTY FINE $25 COURT COSTS $10 03 ARRESTED 02020D 113 AGENCY; -IOWA CITY PD CHARGE NO- 01 IA STATUTE IA236-12 ASSAULT CAUSING INJURY -DOMESTIC ABUSE TRK#: L32982101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA723-4 DISORDERLY CONDUCT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32902101 SENTENCE JAIL SH FINE $20 CREDIT W/T- SERVED 5H 04 ARRESTED 1994 211 AGENCY: IAO 0000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 012456201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 012456201 SENTENCE JAXL 48H FINE $500 05 ARRESTED1996 024 AGENCY: IAO 20200 IOWA CITY PD CHARGE 0 1 IA STATUTE IA321J-2 OWI TRK#: 027165301 COURT DISPOSITION AGENCY: 1A052015J JOHNSON CO DIST COURT COUNT NO- 01 XA STATUTE IA321J.2(B) OPER VER WH TNT (OWI) / 2ND OFFENSE DCI 00366634 PAGE 2 OF 3 DISP EFF DAT 19890515 19090515 19090515 DISP EFF DAT 19900427 19900427 19900427 DSSP RFP DAT 19950223 19950223 No. 0289 P. 8/9 Jan.17. 2013 4:26PM Div of Criminal Investigation DCT 00366634 PAGE 3 OF 3 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 027165301 SENTENCE DISP EFF DAT SUSPENDED JAIL 531) 19970207 JAIL 601) 19970207 FINE $750 19970207 PROBATION - 19970207 023 06 ARRESTED eAO2O2OO AGENCY: IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 3RD OFFENSE TRK#: 100376201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- OS IA STATUTE IA32 J.2(B) OPER VEH WE INT (OWI) / 2ND OFFENSE COURT CASE ID: 06521 OWCR060267 CHARO$ CLASS; MISDEMEANOR CONVICTION TRK#: 100376201 SENTENCE DISP EFF DAT JAIL 14D 20021021 FINE $1500 20021021 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTlOATION, 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 No.0289 P. 9/9 to ARTS Page 1 of 2 CIowa Department of Transportation AO Office of Ddwr Services (Toff Free) 800-532-1121 PO Box 9204, Des Manes, IA 5030E-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/9/2013 DL/ID #: 091FF3450 (IA) Customer #: 4069858 Name: Williams, Michael Class: D ID Status: EXP Revoked Joseph 10/20/2008 A20 Operating While Intoxicated IA IA Address: 2225 10TH ST Audit #: 6600804 DL Status: VAL Issue Date: 01/09/2013 CDL Status: None City/State: CORALVILLE, IA Expiration 12/18/2014 CDL Cert None 522411327 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 2225 10TH ST Restrictions: NONE Restriction None Date of Birth: 12/18/1965 Supplement: Mailing City/State: CORALVILLE, IA Sex: M 522411327 History Information Convictions Citation Date Conviction Date ACD Explanation County IUR 10/23/2001 10/21/2002 A20 Operating While Intoxicated 52 IA 05/05/2010 06/21/2010 Speed (10 mph & under In 35-55 mph zone) 52 IA Operating While Intoxicated Test Refusal/Test Failure Violations Occurrence ACD Explanation JUR 10/23/2001 Al2 OWI Test Refusal IA Sanctions Type Effective End ACD Explanation Occurrence JUR IUR Revoked 11/03/2001 11/03/2003 Al2 OWI Test Refusal IA IA Revoked 10/21/2002 10/20/2008 A20 Operating While Intoxicated IA IA Name: Williams, Michael Joseph DL/ID: 091FF3450 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. ,f 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: http://172.29.254.55/drivers/reports/customerhistoryleerfifieddrivingrecord.aspx 1/9/2013