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Home My WebLink About14-148 *-w Authorization Number )1/— Ay'-' 1 (Office Use Only) Oiravvriiikati mum 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 Cit . Iowa 52240-1826 (319) 356-5090 (319) 356-5497 FAX First Middle. ast 1. Name (� - 1J) c e C20 7 w‘- v‘ 2. Mailing Address I2_0 3 rp._ ve_ ✓A 12_3 1a �C,� 1 A -. s22_ 3. Telephone: Home " — -7 vq 7 Other: 3 l 4 - ul / (-6 ? /o / 3 9 y -7 ti 3 3 4, Prior experience in transportation of passengers: 1-1 V 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? f (0 Type of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? i') 0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? 11 U Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? r) c 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) clerk/taxidrivbadg 03/2014 - I I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 2 t 0 A U b 0 7.� . 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) Sys Signature of Applicant ( '/t ) cvyx,,e,v, Date 712 3-2/V 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 C1n„s‘‘�, tJ . C—2 I v. D")o cj. On this 3 '5-Lday of y+4t yVCtJDY 3.h1AYCFl Not ry Pubic in an or the State of lirwa is Commission Number 729428 • My Com issi n E1x fres ******, -ifs• ....*****-44 * *****.*********.**************.*.********..:t***************a.****************...**********..**.******* 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). /-075-1-/ Sign ure of '-.Ii'e 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. Signa re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 5 '/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update derk/taxidrivbadgeapp2014.dx 03/2014 -9<1. 24. 2014 3:57PM Div of Criminal Investigation IIlNo. 5535 P 1/1 . JUI. LI. LV19 ILi )7rivi Umul CfK — buy UI IMI t,I ly isu, ,r7J7 P. LI L • ,w, STATE OF ICWA ",.. i,fj `mow. ,. t, � S Criminal History Record Check • -.• Kj otvn ` % Request Form e, , , DCI Account Number: Cir-00 .—E (ifepplieebla) To: Iowa Division of Criminal Investigation . prom: City of Iowa City • Support Operations Bureau,1"Floor City Clerk's Office • 213 R.'Ph Street 4101;.Washington Street• . Des Moines,Iowa 50319 . • (515)725-6066 Iowa City, IA. 62240 ' 1725.6050 Par C .Phone; 319.356-5491 Fax: 319.356-a497 I am requesting an Iowa Criminal History Record Check on: Last Name(mandatory) First Name(mandatory) Middle Name(rocomnanded) . lJU2wLa,v.. C. kri5 Nbe_ Date of Birth(maaaamry) Gender(mandeloly) _Social Security Number (recommended) • ZI30 ) 1a -7 —i 11rMale - ❑Female 0q'6 `10 —318 Waiver Information: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 complete criminal history record Information,as allowed by law,always obtain a waiver signature from the subject of the request. Waiver Release:Thereby give permission tot the above requesting omoiol to conduct on lova crhninal historyrecord cheek with the Division of Criminal investigation NCI). Any criminal history data concerning me that is maintained by the DCI may be released os dewed by law. Waiver Signature: / Iowa Criminal History Record Check Results (norm;only) As of 7/Ail/pi , a search of the provided name and date of birth revealed: c I .. No Iowa Criminal History Record with DCI �.:., • —t7 ..,i 0 Iowa Criminal History Record attached, DCT# DCI initials • Received Tiree7Ju1. 2-1, °.2014 12:38PM No, 521 / y" 11* DOTvoivw,„ SMARTER I SIMPLER I CUSTOM 9F31UE S i0v�ratlot gar Office of Driver Services PO Box 9204[Des Moines,iA 50306-9204 Phone:515-244-91241800-532-1121 1 Fax:515-239-1837 www-iawadot.gov Certified Abstract of Driving Record Inquiry Date: 7/19/2014 DL/ID#: 210AD6073 (IA) Customer#: 5360359 Name: Guzman Oyola,Chris Noel Class: C ID Status: None Address: 1205 LAURA DR LOT 123 Audit#: 7770996 DL Status: VAL Issue Date: 02/07/2014 CDL Status: None City/State: IOWA CITY, IA 522451528 Expiration Date: 12/30/2018 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 1205 LAURA DR LOT 123 Restrictions: Corrective Lenses Restriction None Date of Birth: 12/30/1977 Supplement: Mailing City/State: IOWA CITY, IA 522451528 Sex: M History Information CLEAR DRIVING RECORD Name: Guzman Oyola, Chris Noel DL/ID: 210AD6073 Pursuant to Iowa Code §321.10,I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that 1 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: -.4*p 7/19/2014 *':IOWA •'?'8 W. D. O. T. i& Office of Driver Services �4y OAIIIEE� = Iowa Department of Transportation Name: Guzman Oyola, Chris Noel DL/ID: 210AD6073