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Home My WebLink About13-011�r'lll� " 0Y1®r�® CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 + (319) 356-5040 CAL -L- -rZAF5 - (319) 356-5497 FAX -L- First 1. Name L y(c 2. Mailing Address S3 Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) Middle �anJ irAt vi ilf �r] 3. Telephone: Home 319 - 3 11 - 112 T Other: 4. Prior experience in transportation of passengers: Oy + o Q - cnb driver Last [A R- (Office Use Only) 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? yes Tvpe of offense Where When CD1"1"(U;I[1A ISA Iz1 4 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? AL Tvpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? V e ) Type of offense Where When Tmer.ne^ T..r/I -crrcrjr Itk4<4 f D,44at_ o$ 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? )h 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) Alb 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,kAexldrrvb g 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number. 5 3 Trb V , Z . 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 / Date f 0 ?4 44Y+H#H###4H##RR*RRRf*RHYYff 1fYYffY#i#f 4*#+#+###H##}F#*##}}##FR**4*#*FFFYFH}FRf *R*f HFRf *1RFRYFf RRRf1f RfYHfYff 44Y+'fYYfh4#f#Ht#YeHHH#H STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to �V\ r ao before me by On this fiday of in and fo the of Iowa RRRRRRF#*##*#*#H#Hk#i*#i#i#ifiiii#HR#*R#R##**k****#*kk*#k#*i##*k#i*HH#*H#ii#*ikHi*#i#kHif i*Hii#Hii#RRRRHR#HR*R*RR#RkH*k**#Hk**k# k# 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). i nature of Police Chief or designee /--a -1 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. Sign 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 ae<xnawa�wadoaa�zoio.aoc 09/2012 Iowa Department of Transportation Office of Driver Service, (Toll Free) WO -532-1121 PO Box 9204, Des Moines, IA 50306-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/16/2013 DL/ID #: 1537170432 (IA) Customer #: 2745327 Name: Hass, Lyle John Class: A ID Status: None Address: 1252 DUCK CREEK DR Audit #: 4038046 DL Status: VAL Issue Date: 01/22/2010 CDL Status: VAL City/State: IOWA CITY, IA Expiration 01/22/2015 CDL Cert Non -Excepted 522468614 Date: Status: Interstate Endorsements: LTX CDL Med Certified Status: Mailing Address: PO BOX 5388 Restrictions: Corrective Lenses Restriction None Date of Birth: 1/22/1955 Supplement: Mailing City/State: CORALVILLE, IA Sex: M 522410388 CDL Medical Examiner's Certificate Specifics Medical Examiner Last Name_ Medical_ Examiner Suffix_ Medical Examiner License Number Medical Examiner Jurisdiction Medical Examiner Phone Medical Certificate Restriction 1 Medical Certificate Issued Date Medical Certificate Expiration Date Date Added to CDLIS Driving Record Convictions We ...... 1091 History Information CIE OTi P 1593 ))665-2111 ging corrective lenses ?4/2012 ?4/2014 Citation Date Conviction Date ACP Explanation County 3UR 03/17/2008 .05/07/2008 IN01 ilmproper Turn 52 1IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number IUR 12/08/2006 16260282 _JA Name: Hass, Lyle John DL/ID: 153TT0432 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: ""'••w/f��4 1/16/2013 IOWA D. 0. T.:� �f'9BIYEN Office of Driver Services Iowa Department of Transportatlon Name: Hass, Lyle John DL/ID: 153TT0432 STATE OF IOWA ( 1riwffia)l.uistorry, Record Check - -,- --- RbTti t -Form To: Xowa M1491011 of Crf nhial7nvestfgatfon Support OperallensAurone, V Moov 215 E, In' Street be9XolnaS,ToN'a 50319 (sls) �25•bo66 (515) 925-6090 b'asc 1 am re uosung an ToWa Cora! LastlVan7e (ntnndatnry) >(A SS . IWO of Birth mandaro WeYhfO'.l'ilfOYM1tioa: Witlim ho roloosable, per Code of7awo, obtain a wnlvoraltalatm'ofrotn t Cheok PCXA000untAmber;F'- Qf if llol- 17Yom{ QM 05 'r WA- cT99 my crtlxXc's or-FIcH i3 PM(N)MM"IMMUR: t Phonal 119..456-5041 1PPXl -3.%9-356--5/107 vpfale [(b'on►ale 'Y ok/l SoCtal SeOnitV NumbOV lrcooninia a signed Waiverfrom the subf eat oftho repast, q compute OMNI 111401'Y rodord piny riot ;hapten 692.2,1arcotrlplote criminal history record Informntlou, as allowed by 14vi, alivays W17&e?R19&tWe; T hetebyalVa p1mils7lan for tho above requeslfng alroipl to coddpol an Town criminal hfstoryiecard the kw M Ne DTvisfen at'Cominol Tnvostlgstton(Dei), mywfnilnaihlstolydataaonwmfrtgnlolh tlsmalnm/inedbgrhebOlmayborcleasedasaiforvedhylaty. WaAwSlgqulure; I %ti �� a.h hwa Crim9hal i„Iistory Record Check Results. MC] uroonly) As of, a search of theprMded name and data of bitthmealod: ' No Towa Crin)inal Mstory Record found with DCT -' lfowlp Ctimihal F17sto>:y Record attached, DCT-# a N DCX inilials____m. 77 0...x,,.1 T:_. i.. 1n 91117 1.7/DAR'M.' 01104 2013 4:26PM Div of Criminal Investigation No.0289• P. 3/9 INJa.n.17. Jan. 10. 2013 1:34PM City Clerk _ City of Iowa City No. 3129 P. 2 STATE OF IOWA ( 1riwffia)l.uistorry, Record Check - -,- --- RbTti t -Form To: Xowa M1491011 of Crf nhial7nvestfgatfon Support OperallensAurone, V Moov 215 E, In' Street be9XolnaS,ToN'a 50319 (sls) �25•bo66 (515) 925-6090 b'asc 1 am re uosung an ToWa Cora! LastlVan7e (ntnndatnry) >(A SS . IWO of Birth mandaro WeYhfO'.l'ilfOYM1tioa: Witlim ho roloosable, per Code of7awo, obtain a wnlvoraltalatm'ofrotn t Cheok PCXA000untAmber;F'- Qf if llol- 17Yom{ QM 05 'r WA- cT99 my crtlxXc's or-FIcH i3 PM(N)MM"IMMUR: t Phonal 119..456-5041 1PPXl -3.%9-356--5/107 vpfale [(b'on►ale 'Y ok/l SoCtal SeOnitV NumbOV lrcooninia a signed Waiverfrom the subf eat oftho repast, q compute OMNI 111401'Y rodord piny riot ;hapten 692.2,1arcotrlplote criminal history record Informntlou, as allowed by 14vi, alivays W17&e?R19&tWe; T hetebyalVa p1mils7lan for tho above requeslfng alroipl to coddpol an Town criminal hfstoryiecard the kw M Ne DTvisfen at'Cominol Tnvostlgstton(Dei), mywfnilnaihlstolydataaonwmfrtgnlolh tlsmalnm/inedbgrhebOlmayborcleasedasaiforvedhylaty. WaAwSlgqulure; I %ti �� a.h hwa Crim9hal i„Iistory Record Check Results. MC] uroonly) As of, a search of theprMded name and data of bitthmealod: ' No Towa Crin)inal Mstory Record found with DCT -' lfowlp Ctimihal F17sto>:y Record attached, DCT-# a N DCX inilials____m. 77 0...x,,.1 T:_. i.. 1n 91117 1.7/DAR'M.' 01104 r. Jan.17. 2013 4:26PM Div of Criminal Investigation CHARGE NO- 01 IA STATUTE IA321J-2 OWI IOWA CRIMINAL HISTORY DCS 00237819 COURT DISPOSITION MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 JOHNSON CO DIST COURT DATE PRINTED - OPER VEH WH INT OWI 2013/01/17 DCI:00237819 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L14108501 NAME: HASS,LYLE JOHN SENTENCE DOB SEX RAC HGT WOT EYE HAIR SKU POB 19550122 M W 507 160 BLU RLN MED IA 19550126 ADDITIONAL IDENTIFIERS CCH RECORD *'** 01 ARRESTED 19771223 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRK#: L14100401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 DRIVE UNDER INFLUENCE/LIQUOR CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L14108401 SENTENCE DISP EFF DAT JAIL 2D 19780309 02 ARRESTED 19910705 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L14108501 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#: L14108501 SENTENCE DISP EFF DAT JAIL 2D 19911010 FINE $500 19911010 No.0289 P. 4/9 AN ARREST WITHOUT DISPOSITION IS NOT AM INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENP EMENT AGENCIES BY THE DCT. I ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASE ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION