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Home My WebLink About13-009-4 71.r"III CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX First 1. Name wavd Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) Middle Last i�5-gI (Office Use Only) 2. Mailing Address 5-ool An e✓;co n L P 9 /'on ILI 3. Telephone: Home 3/`h' 0,1-u/ it q Other: 413 31 '16 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When /LI,4deF�na✓� -a �w� 2000-62-00 6. Have you been 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? 10 When Type of offense Where When Ape 4j 112 v LV 01 L° icy I G S -l- TTC( n 9 —1'r 0�-rC S 10 r.)cr (' .-f-[i I a5 f' /ylorN 8. Has your driver's license or chauffeur's license been suspended or Type of offense Where in the last five years? - When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) 4f 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) cle"midnmadg 09/2012 I hereby ertify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number / 13 Y Y 6 y S 3 . I understand that if I falsely answer any questions in this application, that this applicati n 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 Applican Date Xd // lliHi###**#**IRflllfllfl4ff#ffHY###ii*k**1*RRflfIfRRH!*ff4flMfflf#1i##fi##*##*#H****#**llffff11f14N1f1fllllffMfiffhi###hIRRIHIkf!#llfiff STATE OF IOWA ) COUNTY OF JOHNSON ) Suqqscribed and sworn to fore me by On this day of --XLLf-L z a SOI ] i«LLIE K. TUTTLE I Notary Public in and for the State of Iowa My Co i sign xpir s 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). 114 gnatu a of Police Chief or designee 117-13 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 ture 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 -i;�'-1-!5 Date aanna"dnroae¢ W2010a 09/2012 Iowa Department of Transportation Office of DriverSemices (Toll Free) 809-532-1121 PO Box.9204, Des Manes, IAA 50305-9204 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/16/2013 DL/ID #: 713YY6453 (IA) Customer #: 681803 Name: Martin, Lanny Edward Class: D ID Status: None Address: 5081 AMERICAN Audit #: 4950812 OL Status: VAL 11/09/2008 LEGION RD SE Issue Date: 01/14/2011 CDL Status: None City/State: IOWA CITY, IA Expiration 04/26/2016 CDL Cert None 08/31/2011 522409071 Date: -Seat Belt Violation _ y _ Status: JIA Endorsements: 3L CDL Med None Status: Mailing Address: 5081 AMERICAN Restrictions: Corrective Lenses Restriction None LEGION RD SE Date of Birth: 4/26/1968 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522409071 History Information Convictions Citation Date Conviction Date ACD Explanation County IUR 04/24/2008_ ____._:05/05/2.008 __._....__..__._._._592 :F04 `Speed,._. __ 152 SIA 09/03/2008 :09/23/2008 ;592 Speed (10 mph under In 35 55 mph zone) 152 -IA 11/09/2008 .01/06/2009 B64 .& 'No Insurance Card,52 '.52 IIA 08/04/2011 ,06/31/2011 F04 Seat Belt Violation_ .._ 52 IA 08/31/2011 110/05/2011 'F04 -Seat Belt Violation _ y _ 152 JIA 03/12/2012 07/03/2012 1M14 iFaII to Obey TrafOc Sign/Signal ,A 152 —JA 06/07/2012 110/10/2012 :F04 .Seat Belt Violation „'_ .. .,,.. 52 _......_ ...... ;IA ._.... ......__ _. 06/11/2012 _-... ,....____...... ._ .._.,....�._ 108/22/2012_ _ __... T04 ..,. .._... __._......._ ..._.. 'Seat Belt Violation _.. _.. ._.._... _.__....__.._ 52 _ SIA 06/20/2012 ...,..__... 09/27/2012 ;F04 Seat Belt Vlolatioh '.52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date _ Case Number _ ,IUR _..__._... ...._...... .... _ ...._..._.__ . .............. .. _......_..... ,- _ . _........__ ...... ... _ _.. ... ' __.... _.- ___ . _......... .. 05/11/2012 1685690 ''.IA Name: Martin, Lanny Edward DL/ID: 713YY6453 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: (Z -.4A_ o9 9914� STATE OF IOWA Criminal History Record Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, I" Floor 215 E. 7" Street Des Moines, Iowa 50319 (515)725-6066 (515)725-6080 Fax I am reauestine an Iowa Criminal History Record Check on: DCI Account Number: 9861-F (if applicable) From: City Clerk's Office City of Cedar Rapids 101 First Street SE Cedar Rapids, IA 52401 Phone: 319-286-5060 Fax: 319-286-5130 Last Name (mana2 ory) First Name_ (mandatory) `Middle Name (mandatory): MC4r+E Lrin F�w�/� .Date of Birth (mandatory) .` Gender (mandatory) . Social Security,Nuinber (mandatory) �tI 6U .Male OFemale 0,99 Waiver Informatian R'ittiout a signed waiver from,the subject of the request, a complete criminal history record may not be releasable,,per:Code of jowa, Chapter 692.2. Foncomnlete,criminal history record;infoimation, as allowed by law, always 'subject obtain a,Nvaiver:sinaturefromthe of.there-ues1. -..r Waiver .Release I hereby give permission for:the above requesting of Bial to conduct an Iowa criminal historyrecord checR with the; Division of Criminal Investigation (D(I). Any criminal history, data coheerning amt DCI may berele"ased as allowed by Waiver Signature: Date Iowa (DCI use only) As of a search of the provided name and date of birth revealed: ❑ No Iowa Criminal History Record found with DCI ❑ Iowa Criminal History Record attached, DCI # DCI initials 7 (08/25/10) PLEASE MAKE ADDITIONAL COPIES AS NEEDED. SING Page 1 of I Single Contact License & Background Check Results Criminal History Background Check Last Name Other Last First Name DOB SSN Name Selection Martin Lanny 1968 -April -26 82781518 Criteria Results Further research is required. Please await DCI's final response for criminal history. Please note: There may be multiple individuals with similar search criteria, requiring more research. Background Check Complete As Of 12/19/2012 12:44:09 PM NOTE: The first and last names, date of birth, and SSN displayed in the abuse registry and criminal history results are just as they were entered on the screen. Billing Account 9881-F Cash Deposit Currently at $729.00 Generate PDF Search Again https://www.iowaonline.state.ia.us/SING/SINGSQLProcess.aspx ' 12/19/2012 S1NU Single Contact License & Background Check Page 1 of 1 Enter Your Search Information Messages ti Last Name Other Last Name Check out the view history button down to the left. It will let you view background checks you have done in the past. First Name Middle Name _ SSN DOB . The fee charged for all criminal history record check requests submitted to the Male 11 Female 11 Iowa Division of Criminal Investigation is non-refundable. If you encounter technical difficulties that prevent you from receiving a response, please contact 1 - Criminal History Check 800-532-1174. check Please note: Your credit card information is not stored, therefore it cannot be released to any company, government agency or person. Help Reset Mew History Log Off Replenish Account Current account balance for 9861-F is $729.00 Session Will Time Out At 1:04:23 PM DCI is currently processing record checks submitted on 12.13-2012 121191201212:44:23 PM https://www.iowaonline.state.ia.us/SING/NSINGSearch.aspx 12/19/2012 9 Jall. L. LV IJ L•I II IYI MY VI 1.1111111161 111VCJt irat lull Submitted 2012-12-1912:44:09.703 IOWA RECORD CHECKREOUEST To: Iowa Division of Criminal Investigation Bureau of identification 215 E. 7th Street Des Moines , IA 50319 (515)725-6066 (515)725-6080 (fax) FORM S REQUEST (* indicates a required field) atn Ce neS in n IOWA CAIMIIYAL HISTORY r cord check On: MARTi1V LANNY Last name* First name* Maiden/Other Last name 4/26/1968 M Date ofl3irth* Gender* I,V. VJJL I. I Page I of I ACCOUNT NUMBER; 9861-F CITY CLERK - CITY OF From: CEDAR RAPIDS 3851 RIVER RIDGE DRIVE NE CEDAR RAPIDS , IA 52402 Phone 319-286-5060 Fax 319-286-5130 Contact Preference: F EDWARD Middle name NO Volunteer 482781518 Social Security number* (DC1 use only) RESULTS As of 1/212013 2:10:26 P VM , a name and date of birth check revealed, CCH Record Attached X DCI4 00374255 No CCH Record Found DCI initials 'waiver on File yes I hereby give permission for the above requesting official to conduct an Iowa criminal history record check with the Division of Criminal Investigation, Any information maintained by the DCT may be released as allowed by law. Received Time Jan, 2. 2013 2:07PM No.2005 bffns://wPbanna inwa onv/cinoa.im;n/Fovkon„oot ao . All in�i�nt e Jan. L. LV IJ L: Ilan U I V VI 1,n minae 111ve5L19aiIU11 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00374255 NAME; MARTIH,LANNY EDWARD DOB SEX RAC HGT WGT EYE HAIR 19680426 M W 508 2'75 BRO BRO ADDITIONAL IDENTIFIERS TAT L ARM TAT R SHLD TAT UL ARM TAT UR ARM PHOTO AVAIL"LE: Y CCH RECORD *** 01 ARRESTED 19880415 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION TRH#: L34035901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L24035901 SENTENCE FINE $150 02 ARRESTED 19880903 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA204-401-3 POSSESSION SCHEDULE I -MARIJUANA TRK#: L34036101 COURT DISPOSITION AGENCY; XA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204-404-4 POSSESSION SCHEDULE I MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L14036101 SENTENCE FINE $150 03 ARRI39TIRD 19860903 A AGENCY: IA0520200 IOWA CITY PD CHARGE NO- Ol IA STATUTE IA714-7 OPERATE MOTOR VEH WITHOUT OWNERS CONSENT TRK#: L34036001 COURT DISPOSITION? AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA724-7 OPER MOTOR VEH WITHOUT OWNER CONSENT Received Time Jan. 2. 2013 2:07PM No.2005 DCI 00374255 PAGE 1 OF 3 DATE PRINTED - 2013/01/02 SKN POB FAR IA DISP EFF DAT 19880722 DISP EFF DAT 19890210 IVU, VJJL I. L a Jan. Z. LV 13 L: 11rivI 01V U �,11m1Oa1 111 V r S l 1& a l I U 11 DCL 00374255 PAGE 2 OF 3 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L34036001 SENTENCE DISP EFF DAT FINE $500 19890213 COURT COSTS $60 19890213 04 ARRESTED 20001107 AGENCY: IA0650000 MILLS CO SO CHARGE NO- 02 XA STATUTE IA124-401-5 POSSESSION CONTROLLED SUBSTANCE/ MARIJUANA TRK#: 040872602 COURT DISPOSITION AGENCY: IA065015J MILLS CO DIST COURT COUNT NO- 02 IA STATUTE IA124-401-5 POSSESSION CONTROLLED SUBSTANCE/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 048872602 LICENSE REVOKED SENTENCE DISP EFF DAT FINE $250 20010221 05 ARRESTED 20010110 AGENCY: XA0780000 POTT CO SO CHARGE NO- O1 IA STATUTE IA124-403. POSSESSION CONTROLLED SUBSTANCE W/INTENT TRK#: 800697501 COURT DISPOSITION AGENCY: IA078015J POTT CO DIST COURT COUNT NO- O1 1A STATUTE IA124-401(5) POSSESSION CONTROLLED SUBSTANCE CHARGE CLASS: MISDEMEANOR CONVICTION ' TRK#: 800697501 SENTENCE DISP EFF DAT JAIL 2D 20010625 06 ARRESTED 20080109 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124,401(1)(d)-F CONTROLLED SUBSTANCE VIOL, TRK#: IA0036F01 COURT DISPOSITION AGENCY:IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124, 401(1)(D) -F CONTROLLED SUBSTANCE VIOL. COURT CASE ID: 06521 FECRO81963 CHARGE CLASS: NON CONVICTION Received Time Jan. 2. 2013 2:07PM No, 2005 IYV. VJJL I. J Jan. 2..ZUli Z;IZYM Uiv oT Criminal Investigation No.0§52 P. 4 DCI 00374255 PAGE 3 OF 3 TRX#j IA0036FOI SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20060711 FINE $350 20080711 PROBATION 3Y 20060711 DISCHARGED FROM 20100224 DEFERRED JUDGEMENT 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 'THHE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BA D ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD CO S THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION Received Time Jan. 2. 2013 2:07PM No, 2005