HomeMy WebLinkAbout15-024 • Authorization Number /_i T
1 1 (Office Use Only)
,/,.111,42Ist .61
ameguilanir
CITY OF IOWA CITY APPLICATION FOR TAXI/MOTORIZED PEDICAB VEHICLE DRIVER
(Police Department review must be made between 8 a.m.to 3 p.m., Monday—Friday.)
410 East Washington Street
Iowa City. Iowa 52240-1826 Failure to complete the "required"information will result in denial of the application
(319) 356-5040
(319) 356-5497 FAX
Firsts Middle Last
1. Name (REQUIRED) _.1cn5411 1l vIC .5 t-e
2. Mailing Address (REQUIRED) 27.6 rNE clkRo
3. Contact Information (REQUIRED) Email: ye;i-tioe yc�,rc'.cc.,� Cell Phone: .fi9-3(..2-3/6 S
4. Prior experience in transportation of passengers: 2co'-ze,)1 5(2,,rr-1.e
l4pic1s )V / 2 i i -- PrPsep71—: Qri,ret 4ivert" 56'17/i? Se- iry eedck hp, 4S GFS
5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere?
Type of offense Where iwf��. . �
" _ _ u""4.
t
When .::�,,:�z ,
, z
6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five
years? NQ
Type of Offense Where When
7. Have you been convicted of any traffic offenses in the last five years?
Type of offense Wheren When
ri 3�Yt e , .2e) if
8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /x 0
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) .
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).
(OVER FOR REQUIRED SIGNATURE AND NOTARY)
09/2014
I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number
c?C / 013 C() 3 . 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 -t uL Date ,2 F- k �61
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.
STATE OF IOWA
COUNTY OF JOHNSON )
Subscribed and sworn to before me by .7 05 r-0 t., V: Q *- X . On this day of
Jci
C -c j co2_,.
VIENDY S.11111 Notary Public in" nd for the State of I a
"an:�omrmesan NumbAr 22 428
• My Comm ssion pines
-
************************ **********************************************************************************************
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).
2( 7)-
Signature • Po ce Chief 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.
/4.5 : 0 - /5
Signa e of City Clerk or designe Date
Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 51/2"
(height) and prominently displayed to all passengers.
************************************************************************************************************************************************
Office Use Only
Approved application
DCI report
State certified driving record
Website update
Clerk/TAXIDRIVBADGEAPPL92014amended.DOC 09/2014
Dec. 1b. 2014 ii:htlAM Div of Uriminal Investigation No. / III r. i/t
Page lof1
Submitted 2014-12-12 14:05:48.667
. 7 `aq.s IOWA RECORD CHECK REQUEST
inn .1- i ;:;::::.,2:•;;'
. FORM S
ACCOUNT NUMBER:9861-F
Iowa Division of Criminal CITY OF CEDAR.
#_; : To:Investigation • From: RAPIDS-CITY CLERK
Bureau of Identification 101 First Street SE
215 B.7th Street CEDAR RAPIDS , IA
52401
Des Moines, IA 50319
(515)725-6066 Phone319-286-5060
(515)725-6080 (fax) Fax 319-286-5130
Contact Preference:F
REQUEST
(* indicates a required field)
I am requesting an IOWA CRIMINAL HISTORY record check on:
SETTER JOSEPH 'VINCENT
Last name* First name* Middle name
NO
s.� •-
Maiden/Other Last name Volunteer
.
•
2/9/1947 M 296382659
Date of Birth* Gender* Social Security number*
(Muse only) RESULTS .
As of 12116/2014 8:41:08 AM,a name and date of birth check revealed:
CCII Record Attached X DCIif 181604 No CCH Record Found
DCI initials Waiver Signature on File yes
I hereby give permission for the a ove 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.
•
` httn.s://wehanns.inwa..anv/sinnndmin/PawRPmlesf ncnx 12/16/2014
Uec. lb. 2014 tl:hdRM Uiv of Criminal investigation No. 1111 V. 2/2
IOWA CRIMINAL HISTORY DCI 00161604
MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1
DATE PRINTED-
2014/12/16
DCI:00191604
NAME: SEITER,JOSEPH VINCENT
DOB SEX RAC HGT WGT EYE HAIR SKN PCB
19470209 M W 510 187 BLV BRO
ADDITIONAL IDENTIFIERS
CCH RECORD ***
01 ARRESTED 19720423
AGENCY: IA0070100 CEDAR FALLS PD
CHARGE NO- 01
INDECENT EXPOSURE
TRIG!: Z13697801
COURT DISPOSITION
AGENCY:
COUNT NO- 01
DISTURBING THE PEACE
CHARGE CLASS: MISDEMEANOR CONVICTION
TRK : 213697801
SENTENCE DISP EFF DAT
SUSPENDED JAIL 30D 19720621
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
i
t t"
'19
•
SING Page 1 of 1
/41
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 296382659
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.
REMINDER: Please check the transaction log for the final results by clicking on the
View History Button after logging in.
Background Check Complete As Of 12/12/2014 2:05:49 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$4419.00
Generate PDF
_Search,Again_ ,
https://www.iowaonline.state.ia.us/SING/SINGSQLProcess.aspx 12/12/2014
Air, .s� STATE OF IOWA • ~s• ��
�l 10NA Criminal History Record Check -a ~ "' "" ; •
t .n.. „-
h,
P24,C1 ,r' Request Form $�. 'wi;
•
• DCI Account Number: 9861-F
(if applicable)
To: Iowa Division of Criminal Investigation From: City Clerk's Office
Support Operations Bureau,1st Floor
215 E.7t°Street City of Cedar Rapids .
101 First Street SE
Des Moines,Iowa 50319 Cedar Rapids,IA 52401
(515)725-6066
•
(515),254080 Fax
Phone: 319-286-5060
Fax: 888-966-0171
I am requesting an Iowa Criminal History Record Check on:
Last Name (mandatory) First Name(mandatory) Middle Name (mandatory)
SC ) 7E: R j-OCEP H . Vt. Nc,Cnl -a
-
Date of Birth (mandatory) Gendernd (mandatory) Social Security Number (mandatory)
2 _ 9 — /947
)(Male ❑Female 94 -39- 2 (0 7
Waiver Information:Without a signed waivererfrom the subject of the request,a complete criminal history record may not
be releasable,per Code of Iowa,Chapter 692.2.For complete criminal history record information,as allowed by law,always
obtain a waiver signature from the subject of the request.
Waiver Release:I hereby give permission for the above requesting official to conduct an Iowa criminal history record check with the Division of Criminal
Investigation(DCI). Any criminal history data concerning me that is maintained by the DCI may be released as allowed by law.
9493--12_
Waiver Signature: Date /2- /2-7 Ai j
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
DCI-77 (08/25/10)
PLEASE MAKE ADDITIONAL COPIES AS NEEDED.
A'TS Page 1 of 1
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SMARTER I EIMPLAR I CUSTOMER DRIVEN u.,� ,a...: , ,, .. _,R
Office of Driver Services
PO Box 920 Des Moines,IA 50306-9204
Phone:515-244-9124 1800-32-1121 I Fax:515-239-1937
www to A'adoi-gov
Certified Abstract of Driving Record
I quiry Date: 12/11/2014 DL/ID If: 901880938 (IA) Custo er#: 5119644
Name: Seater,Joseph Vincent Class: D ID St tus: None
Address: 220 19TH ST NE APT Audit#: 4333050 DL St tus: VAL
E324 Issue Date: 05/07/2010 CDL S atus: None
City/State: CEDAR RAPIDS, IA Expiration 02/09/2015 CDL Cort None
524025483 Date: Statue:
Endorsements: 3 CDL hied None
Status:
M iling Address: 220 19TH ST NE APT Restrictions: NONE Restriction None
E324 Date of Birth: 2/9/1947 Supplement:
M.fling City/State: CEDAR RAPIDS, IA Sex: M
524025483
History Information
C•nvictions
Cisat:on tate Conviction Date. ACO Explanation County JUR
0 /08/2014 03/27/2014 S92 Speed (10 mph &under In 35-55 mph zone) Benton IA
N.me: Seiter, Joseph Vincent DL/ID: 901880938
Ptrsuant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do
h reby 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
arj 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.
I
Il witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa
th s date:
.-y"
pENICIf v,
-oQ:•""••.f%"1 12/11/2014
IA.:* IOWA :*% .ic ,�
t.:.D. O. T. ;W% ._ : r
,,'''11,i Oaivil.4s Iowa Office
of Driverrof
Services
anspor<atlon
N me: Seiter, Joseph Vincent DL/ID: 901880938
http://172.29.254.55/drivers/reports/eustomerhistory/certifieddrivingrecord.a.px 12/11/2014