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Home My WebLink About13-005r t !1 -4 ir'Ill� CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) 13-5 (Office Use Only) 1. Name First s SQ Middle Last S e r' t -2.r J 2. Mailing Address �4 z p - r4 — Sr NE 4er E3? -4 -eo+ IR t" -Js )/l 5.2gd z 3. Telephone: Home 3) 9 3(� Z 313 9 Other: 4. Prior experience in transportation of passengers: 2 ueors (-Vt 4n0- Plg2w liars Q4YS Aiyp&,, S%7U 0-1P .ley c -L. d o 1-, l U it 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Y9 Where b; s i-,r� r.b inti teaC14C Czja—tj-,IIs When )972- 6. 972- 6. Have you be reconvicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? �C� Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When When 8. Has your drivers license or chauffeurs license been suspended or revoked in the last five years? 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) A/ 0 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) d.N .,dnW.d9 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number C/ O 5 Pj O 9 3 8 . 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 Pe ist_ 1.. Date s 2S STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by JoSe,�\%... „� S2i�eY On this � day of iblic in and for the State of Iowa *k**kRk#*R*#R*##RR*#R*RRRlfklffkffRffR#R*f*Rf*RRfR**Rf**RRRRR**R**R*Rk**R#Rf#R*R**#RRk#RR**#*f*R#*#R*RRIRR*R*R*ff*Rf*!ff*ftlflfftf*R11fRRk*#**R* 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). a Sigriature of oli hief 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. ' Nzxl : l ' �� Sign�at, a 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 deMl"ad adgeapp2010tl 09/2012 WNW STATE OF IOWA Criminal History Record Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, I" Floor 215 E. 74 Street . Des Moines, Iowa 50319 (515)725-6066 (515)725-6080 Fax I am recuestina 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 (mandatory) First Name (mandatory) Middle Name (mandatory) '.,S"�'�. { air : ;:a_s e,h �� ;� ►' '.. . Date of Birth (mandatory) Gender (mandatory) Social Securi Number (mandatory) ' j .` � q ❑Female ale Waiver Ittforfnatio3t: Without a signed waiver from the subject of the request a complete criminal history record may not be releasable, per Code of Iowa, Chapter 692.2. For Kni tete criminal history record information, as allowed by law, always obtain a waiver si ature from the subject of the request. Wziver Release: I hereby give permission for the above requesting official to conduct an Iowa criminal history record check with the Division of Criminal Im¢mggation(DCI). Any criminal history dataconceming me th(aat is�'a ttainedby the DO may be released as allowed bylaw. . Waiver Signature:"" Date V Iowa Criminal History Record Check Results (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 SING Page 1 of 1 ILI Single Contact License & Background Check Results Criminal History Background Check Last Name Other Last First Name DOB SSN Name Selection Seiter Joseph 1947 -February -09 96382659 Criteria Results Further research is required. Please await DCI's final response for criminal history. Please note: There maybe multiple individuals with similar search criteria, requiring more research. Background Check Complete As Of 12/10/2012 4:15:55 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 9861-F Cash Deposit Currently at $954.00 Generate PDF Search Again, _ . https://www.iowaonline.state.ia.us/SING/SINGSQLProcess.aspx 12/10/2012 1 --- ��. .vic ic�nn� vi v� vi iwinu� au. vualfivalvn Submitted 2012-12.10 16:15:55.363 IOWA RECORD CHECK REQUEST 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) ia_rt�puestin�2 an IOWA CriIM]NnI.IIISTOA'Y record check on• I". V IV II. I/ L PagC L UL 1 ACCOUNT NUMBER; 9861-F CITY CL) Rx - CIT'Y' OF From: CEDAR RAPIDS 3851 RIVER RIDGE DRIVE NE CEDAR RAPIDS , IPL 52402 Phone 319-286-5060 Fax 319-286-5130 Contact Preference: F SEITER J'OSEPR VINCENT Lastname* Firstname* Middlename NO Maiden/Other Last name Volunteer 2/9/1947 M 296382659 Date of Birth* Gender* Social Security number* (DC1 use only) RESULTS As of 12117/201212;06;02 PM . a name and date of birth check revealed: CCH Record Attached x ACI # 181604 No CCH Record Found DCT initials 'Waiver on Mle es . 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 DCI may be released as allowed by law. Received Time Dec.17, 2012 12:40PM No. 1939 https://webapps.iowa.gov/singadmin/FaxRequest.asvx 12/17/2012 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY / DCI:00181604 / NAME: SEITER,JOSEPH VINCENT fV DOB SEX RAC HOT WGT EYE HAIR 19470209 M W 510 167 BLU BRO ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19720423 -DCI 00181604 PAGE 1 OF 1 DATE PRINTED - 2012/12/17 SKN 'POB AGENCY: IA0070100 CEDAR FALLS PD CHARGE.NO- 01 •INDECENT EXPOSURE TRK#: Z13697801 COURT DISPOSITION AGENCY: COUNT NO- O1 DISTURSING THE PEACE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 213697801 SENTENCE DISP EFF DAT SUSPENDED :TAIL 30D 19720821 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 EOT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCT, IN THE ABSRNCE 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 Received Time Dec. 17. 2012 12:40PM No. 1939 .... V I v I .. C/ L CIowa Department of Transportation AW Office of Driver Services (roll Free) 804-532-1121 PO Box 9244, Des Moines, IA 50306-9204 515-244-9124 FAX: 515-239-1837 Inquiry Date: 12/11/2012 Name: Selter, Joseph Vincent Address: 220 19TH ST NE APT E324 City/State: CEDAR RAPIDS, IA 524025483 Mailing Address: 220 19TH ST NE APT E324 Mailing City/State: CEDAR RAPIDS, IA 524025483 Name: Selter, Joseph Vincent DL/ID: 901BB0938 Certified Abstract of Driving Record DL/ID #: 901BB0938 (IA) Class: D Audit #: 4333050 Issue Date: 05/07/2010 Expiration Date: 02/09/2015 Endorsements: 3 Restrictions: NONE Date of Birth: 2/9/1947 Sex: M History Information CLEAR DRIVING RECORD Customer #: 5119644 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: 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%'4 12/11/2012 IOWA D.O.T.' ' 77"— S�E^ Office of Driver Services y�\i781YE= Iowa Department of Transportation Name: Seater, Joseph Vincent DL/ID: 901BB0938