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Home My WebLink About15-001 Authorization Number r 1 (Oftice u... Jnly) III v1 wino APPLICATION FOR TAXI/ MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made between 8 a.m.to 3 p.m., Monday—Friday.) 410 East Washington Street wa Cit . Iowa 52240-1826 Failure to complete the "required"information will result in denial of the application L4JI9) 356-5040 (319) 356-5497 FAX First /74e.licci Mid 051 - Last //cC k 1. Name (REQUIRED) �/ �/ t/ 2. Mailing Address (REQUIRED) .i ./ (O / / /- L /3 5 'Z 2X/G 3. Contact Information (REQUIRED) Email:HAVR 0,7771-- C i) Cell Phone:01 J 5�� 98,7/ 4. Prior experience in transportation of passengers: (1,0 Y�- 0 ' c-.0 14-f /7°.V / /KZ) /5-‘45 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? N!.9 Type of offense Where 71,41:7 • ) r" ,11; .�. 6. Have you benconvicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? //V Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? /VC) C) Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /VC Type of offense Where When 9. Have you e er 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 per"° 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 hayg sued to me by the Iowa Department of Transportation a valid Chauffeur's license number ) / b r . 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 w't ;II 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 ,At° '/ Date �J, i 22/ lqJ YOU ARE NOT VALID TO DRIV * 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 ) s/VCQ v bscribed and sworn tobefore me by '0-\\c�\a,s 0 J . �Q . On this l ,us.)- 7 day of Dc ' ao) . — Notary Public in aticTifor the State o Iowa r- 4, WENDY MAYEN Conionision Number 72$4,24 I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that •-re is no info ation which would indicate that the issuance would be detrimental to the safety, health or welt- - of r•sidents , • City of Iowa City(Title 5, Chapter 2, City Code). A AI/ !p o Z �, Si. atur-of P. h or designee Dae 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. /1 . • K • )04•(_/ //V/5 Sighatur's-of City Clerk or designee / ate Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 5 1/2" (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 ..._ , . , IIAIADOT , 3 , www lowadot gov, .SMARTER I SIMPLER I CUSTOMER ORIV N• .. Office of giver Services PO.BoX 9204 I Cies Moines,IA 50306-9204 Phone:515-244.9124 J 800-532-1121 I l=ax:515-239-1837 www_iowadoLgov Certified Abstract of Driving Record Inquiry Date: 12/23/2014 DL/ID #: 431xx0158 (IA) Customer#: 1603765 Name: Heck, Mauro Jose Class: D ID Status: None Address: 1 JOYFIELD LN Audit#: 8714320 DL Status: VAL Issue Date: 12/23/2014 CDL Status: None City/State: IOWA CITY, IA Expiration 01/22/2023 CDL Cert None 522454440 Date: - Status: Endorsements: 3 CDL Med None Status: Mailing Address: 1 JOYFIELD LN Restrictions: NONE Restriction None Date of Birth: 1/22/1959 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522454440 History Information Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number _ JUR 12/10/2011 662444...,_ V . ...- ,. _ IAS Name: Heck, Mauro Jose DL/ID: 431xx0158 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 ;et Ankeny, Iowa this date: — Ca, C", C_ _- " " I3 -. 'VEHICLE`\IN --d C^: c11 I A..,,.....•.,4i�' 12/23/2014 P ,,�. V.. , �i IOWA �, ' ' is i s c 4 r _f` %/I.% D. I'',�ilodf''PNEP�....= Office of Driver Services ��.�...�� Iowa Department of Transportation Name: Heck, Mauro Jose DL/ID: 431xx0158 Dec. .30. 2014 10: 12AM Div of Criminal Investigation No. 7083 P. 4/5 liec. Ly. L(114 lI:J/rM (,ity Clerk — City of Iowa City ' No. 5492 P. 2 S.d "��ma 4r fl V. Crc>i�a1�n iI History mrry Iveco d Check �' y'`� �:�: � STATE OF IOWA Request Form OD_4 ---- Irl - -- - „►•s,c,.,.`‘ --. Lis DCI Account Number: 60-A.--F of applicable) To: Iowa Division of Criminal Investigation From; City of Iowa City Support Operations Bureau,P'liloor City Clerk's Office 215 E.71'•Street 410 E.Washington Street Des Moines,Iowa 50319 (515)725-6066 Iowa City, IA. 52240 (515)725-6000 Fax , Phone: 319-356-5041 44[1b • Pax: 319-356-5497 • • I am requesting an Iowa Criminal History Record Check on: Last Name (n,endatory) First Name(mandatory) Middle Name(recommended) Date of Birth(mandatory) gender(mandatory) SO ta!Security Number(recommended) ,fir ,p 7'f-- 9 /� rz( •y r/'-l'r' � � .��/ 1:! i aIe ❑BemaXe ,,,,,��/// «(JJJ T / �l� Waiver Worn-radon:Without a signed waiver from the subject of the request,a complete criminal history record may riot ho releasable,per Code of Iowa,Chapter 6912,For complete criminal history record information,as allowed by law,always obtain a waWel-signs ture from the subject of the request, WilIver Release:t hereby give permission for tho above requesting i' ial I• duct en Iowa criminal history record check with the Division of Criminal LtvorlioaIion(Doi. Any criminal history data coneemhlg two oP s ed b •Da may be released as allowed bylaw. Waiver Signature: -...i.10-....... Iowa Criminal llisforxRecord Check Resultsm -t;s�aniy)�. :q- • L As of 29Z ;3 U {!�/ , a search of the provided name and date of birth revealed: I . :-7c, cam. 0 No Iowa Criminal History Record found with DCI 3 :- - ; I- 5 XIowa Criminal History Record attaohed,DCI# /, / `'t DCI initials, a Received Timep,De,c,,29..02014 12:35PM No, p030 Dec.30. 2014 10: 12AM Div of Criminal Investigation No. 7083 P. 5/5 IOWA CRIMINAL HISTORY DCI 00430917 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- 2014/12/30 DCI:00430917 NAME: HECK,MAURO JOSE DOB SEX RAC HGT HOP EYE HAIR SKN POB 19590122 M W 605 230 GRN ERO FAR XX ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19911130 AGENCY: IA0100000 BUCHANAN CO SO CHARGE NO- 01 IA STATUTE IA321A-17 FAIL/FILE SR TRIO: L41012601 COURT DISPOSITION AGENCY: IA07.0015J BUCHANAN CO DIST COURT COUNT NO- 01 DRIVE WHILE UNDER SR SUSPENSION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L41012601 RESTITUTION SENTENCE DISP EFF DAT PLEAD GUILTY 19920403 JAIL 2D 19920403 COURT COSTS 19920403 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OP 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. DI'V'ISION OF CRIMINAL INVESTIGATION • J ` .�- fa=.qtr. ` J �. tr y 1 •4 i •• c:),73W ThwnGf o w