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Home My WebLink About14-196 � II Authorization Number /q—/ 9 ( r (Office Use Only) APPLICATION FOR TAXI/MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made 410 East Washington Street between 8 a.m.to 3 p.m., Monday–Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First Mi die Vast 1. Name ��a 1/e✓\ 6-r 2. Mailing Address . 13 5" aey 3f- A/ L, 3. Telephone: Home 3,,1 S c/j( Other: 4. Prior experience in transportation of passengers: • / r1, ,)tin 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When p�) 1/4-,4..e / 2 6. Have youbge convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? / a Type of Offense Where � When 7. Have you been convicted of any traffic offenses in the last five years? 4/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?/176 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) /V0 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) clerkllaxidrivbadg 03/2014 0 , I here,b.,yy certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 632.,' /,-`-(' ` . 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 documen s 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) �/ /— Ail Signature of Applican I4� tea; ; � � Date 3 ,1 . 9/ YOU ARE NOT VALID T /) o 13,-,Y. IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authori -d 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 C' "-`7'``-'11.-e- \\\(P--'^ Q“\ �\-\ � On this .J.--- \ day of S44-\-Q\ \_ __- :A:1 CA Stof and for the Staof I 1 -)\\1 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 tree issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City(Title 5, Cl-.apt,. City Code). ,e ''‘Id Signa re of P. cz, 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. 74f-es ,- -.) 9-- j. --- / 7/ Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/z" (width) and 51/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update clerldtaxidrivbadgeapp2014.doc 03/2014 iAult. 14. 2014 4: 04PM CDi ; of Criminal yInvestigatioo5. NNo. 7428 PP. 1/4 ili • � ) era.,, pP, 4 STATE OF IOWA • �..7- r „ +' $ , Criminal ryRecord Check ' •s'A.0•:.,:),.(<klmvd 4 "„ v . - Request Forum ' N :`- = ruo� .? • ACI Account Number: L --F itappltcable) To: Iowa Division of Criminal Investigation From; City of Iowa City Support Operations Bureau,l't Moor City Cleric's Office • 215 E.71"Street 410 E.Washington Street Des Moines,Iowa 50319 (S15)725-6066 Iowa City, IA 52240 • (515)7254080 Fax Phone: 319-356-5041 • - . Fax: 319-356-5497 •I am requesting an Iowa Criminal HistoryRecord Check on: haat Name (meedalary) First Name(nsendetory) Middle Name(recommended) Date of Birth (>noldelo v) Gentler(mandemq) Social Security Number(recommended). 7/36A,C MMaie ❑Female 5÷3 ) Y 3 Waiver Information:Without a signed waiver from the subject of the request,a complete criminal history record niny not . be releasable,per Code of Iowa,Chapter 6924,roc•complete criminal history record information,as allowed by law,alwaya . obtain a waiver signature from the subject of the request. Waiver Release:Ilmoby glvo permission for th I abovo roquosling offlo'.1 to conduct an kwa criminal history record deck with rho Division ofcriminal • Investigation(DCI), Any criminalhistory dolaconcern! gme[ha ,'nal. dbyby be ss iy be reloeie4 a allowed by Jew. f � Waiver Signature: _— - ,_ AnPr w t eL Jt A CY a p� Jtowra Criminal Alston?'Record Check Results • per use only) • As of k' (`i"(Li , a search of the provided name and date of birth revealed: - G,'i No Iowa Criminal History Record found with D CI • ,`.' -,, ;.,, '', A, Iowa Criminal I-Iistory Record attached,DCI# ON - • DCI initials chi TIM 77/no ti Ino, Received Time Aug. 12. 2014 3:05PM No. 6851 Aug, 14. 2014 4: 04PM Div of Criminal Investigation No. 7428 P. 2/4 IOWA CRIMINAL HISTORY DCI 00359638 FELONY CONVICTION PAGE 1 OF 3 DATE PRINTED- 2014/08/14 DCI:00359639 NAME: HARTNETT,OEORGE ALLEN HARTNETT,GEORGE ALLEN II DOB SEX RAC HGT WGT EYE HAIR SKN POE 19650730 M W 511 210 BLU BLN FAR IA ADDITIONAL IDENTIFIERS SC R WRIST TAT L SHLD TAT R SHLD CCH RECORD **4 01 ARRESTED 19870327 AGENCY: IA0520200 IOWA CITY PD CHARGE N0- 01 IA STATUTE IA321A-32 OPERATE W/O FINANCIAL RESPONSIBILITY TRIO; 132013401 COURT DISPOSITION AGENCY: IA052015.7 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVING UNDER SUSPENSION CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L32013401 SENTENCE DISP EFF DAT FINE $150 19870427 02 ARRESTED 19870425 AGENCY; IA0520000 JOHNSON CO SO CHARGE N0- 01 IA STATUTE IA321-279 ELUDING TRK#: L32013501 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-279 ELUDING CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32013501 SENTENCE DISP EFF DAT JAIL 140 19870014 FINE $300 19870014 PROBATION 2Y 19070814 SUSPENDED 76D 19870814 REVOKED 14 DAYS JAIT. 19881115 03 ARRESTED 19880129 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-218 DRIVING WHILE REVOKED TRK#: L32013601 A o, 14. 2014 4:04PM Div of Criminal Investigation No. 7428 P. 3/4 DCI 00359638 PAGE 2 OF 3 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-218 //RXVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32012601 SENTENCE JAIL 2D 04 ARRESTED 19881115 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-218 DRIVING WHILE REVOKED TRK#: L12013701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-218 DRIVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32013701 SENTENCE DISP EFF DAT JAIL 2D 19881115 05 ARRESTED 19980706 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 032277601 CHARGE NO- O5 IA STATUTE IA713-3 BURGLARY 1ST TRK#: 032277605 COURT b1SPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J-2 OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032277601 SENTENCE DISP EFF DAT JAIL 2D 19990409 FINE $1,000 19990409 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 0S IA STATUTE IA713-6A BURGLARY 3RD DEG CHARGE CLASS: FELONY CONVICTION TRK#: 032277605 SENTENCE DISP EFF DAT Au. 14. 2014 4:05PM Div of Criminal Investigation No. 7428 P. 4/4 DCI 00359638 PAGE 3 OF 3 PROBATION 3Y 19990409 SUSPENDED 5Y 19990409 365D O HOPE HOUSE;SUBS ABUSE TRTMT COURT DISPOSITION AGENCY: TA052015J JOHNSON CO DIST COURT COUNT NO- 06 SA STATUTE IA706-2A(2) (B) DOMESTIC ASLT CAUSING INJURY CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032277606 SENTENCE DISP EFF DAT JAIL 365D 19990409 BATTERER PROGRAM FINE' $250 19990409 '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 �'( " SMARTER I SIMPLER I CUSTOMER''DRIVE�E' i a Ovvvvvv 9OV 1 , Office of Driver Services PO Box 92041 Des Moines,IA 58306.9204 Phone:515-244-9124 i 800-532-1121 i Fax:.515-239-1837 www.iowadotgov Certified Abstract of Driving Record Inquiry Date: 9/3/2014 DL/ID#: 082CC2985 (IA) Customer#: 2699268 Name: Hartnett,George Allen II Class: A ID Status: None Address: 2505 DAVEY ST NE Audit#: 7060915 - DL Status: VAL Issue Date: 06/21/2013 CDL Status: VAL City/State: IOWA CITY,IA Expiration 07/30/2018 CDL Cert Excepted Intrastate 522407873 Date: Status: Endorsements: LN CDL Med None Status: Mailing Address: 2505 DAVEY ST NE Restrictions: Corrective Lenses Restriction None Date of Birth: 7/30/1965 Supplement: Mailing City/State: IOWA CITY,IA Sex: II 522407873 History Information Convictions Citation Date Conviction Date ACD Explanation County3UR 10/24/2011 :11/14/2011 1Vehicle Overweight 7ohnson ;IA Name: Hartnett,George Allen II DL/ID: 082CC2985 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: •4y 111 =tOS`• ..4 t4 9/3/2014 4 IOWA ' d i oiciA ' ' 4 I1 rvices 1 ge- , IowaDepartment Office of Driver erf Transportation Name: Hartnett,George Allen II DL/ID: 082CC2985