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Home My WebLink About14-106 _ Authorization Number f % — I0 (12 I _ 1 (Office Use Only) ulI ter, 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 5 2240-1 826 (319) 356-5040 (319) 356-5497 FAX First Middle Last 1. Name ab\vl tem- eyes 2. Mailing Address a(u)Q ,.)-✓1 t l'7 C� cook_ C) ► �! �c C-V O 19-43. Telephone: Home 3)i- 9 3 lv- aO g7 Other: 319- 4. . Prior experience in transportation of passengers: y,eS pec/1'4 e /ccS+ Yec r 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? %j Type of offense Where When 1� ekVi C -1\c ' a.a.‘ CA- 3 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? %\o Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? none Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Iib 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) cled taxidrivbadg 03/2014 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number �f 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) ZA-SSignature of Applicant`/ Y Date C -/Z/ 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 by9\o\O‘h L, QS On this ' ) day of • blic in and for the State orrowa 1311M ************************************************************************************************************************************************ 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). • v( 3-t3 Signatur: of Pl 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. i1 Signature-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 de,k/taxidrrvbadgeapp20i 4.doc 03/2014 - 'Aur. 11. 2014410:37AMM Div of Criminal Investigation No. 7343_ P. 3/4 vitt' r• No. 475') Y. _I s L-C.. L; t.- . • r STATE �q ¢`t OF IOWA t • fi•t twCraninaHistory eco Check • is, ; <- I PCava ; , '`c -5 L.' • Citk.i.. k-Ca I Request Form . 1iye;, • . :v DCT Account Number;!-(�� (if applicable) To; Iowa Division of Criminal Investigation From: City of Iowa City Support Operations Bureau,1"Floor City Clerk's Office 215 D.7th Street 910 D,Washington Sfree( Des Moines,Town 50319 • • (515)125-6066 — — —. — .—. — — — _-Iowa City, IA.52240 --. .— __ __ _ (515)'/25-6000 Fax —'— . phone: 319-356-5041 Farl 319-356-5497 • • I am rs uesting an Iowa Criminal History Record Check on: )Last Name(mandatory) FIrst Name(mandato ) Middle Name(eccommcndn (7 eN e S < r ?IJ 11 ✓L t_r `e--- Date of Birth(menda,ory)I Gender(mandatory) Social Security Number occommended) • /b' * --- Il (OL) M .-J ale romale 3(0I —$! 2-CS Waiver ltifoltnation:Without a signed waiver from(hesubject of the request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 692,2.Thr complete criminal history record information,as allowed bylaw,always obtain a waiversignature from the subject of the request, Waiver.Release:Ihereby give pcnnIssion faith eboye requesting andel to conduc(in lowa criminal ldslory record amok with the Division oltrimin al investigation(DCf). Ahycriminal history dale Cenirn het Is mined bythebCtmaybereleased asallowed bylaw_ ix'aiVerSignrrlar ; '{i'//ll)) e9Q , • • Iowa Criminal History Record Check Results (pClnso only) • As of CL`` ( t k k 1 , a search of the provided name and date of birth revealed: •-•!:::' "r r. aJ ; frit? :d C 'i �O 1-'ii; No Iowa Critninal History Record found with DCI ` r, • - ... y; - . "{Int. Iowa.Criminal History Record attached,DCI# "1 0 S s c , Daitlitials - • • Received Time'2Apr.• 0.2014 1 :52PM No. 4660 Apr. 11. 2014 10: 37AM Div of Criminal Investigation No. 7343 P. 4/4 IOWA CRIMINAL HISTORY DCX 00708915 • MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- DCI:00708915 2014/04/11 NAME: DENNIS,ROBIN LEE DOB SEX RAC HGT WGT EYE HAIR SKN FOB 19641024 F W 506 195 HAZ BRO IL ADDITIONAL IDENTIFIERS TAT BACK TAT CHEST TAT R HND CCH RECORD *** 01 ARRESTED 20031006 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA726-6 CHILD ENDANGERMENT TRK{: 100973901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA723.4(2) DISORDERLY CONDUCT - LOUD AND RAUCOUS NOISE COURT CASE ID: 06521 FECR066674 CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 100973901 SENTENCE DISP EFF DAT FINE $50 20040114 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THYS 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 DDT \� . www.iowadot.gov SMARTER I SIMPLER I CUSTOMER DRIVEN .____..___ .� Office of Driver Services PO Box 9204 I Des Moines, IA 50306-9204 Phone:515-244-9124 1900-532-1121 I Fax:515-239-1937 w w.iowadot.gov Certified Abstract of Driving Record Inquiry Date: 4/9/2014 DL/ID#: 284AD4320(IA) Customer#: 475390 Name: Reyes,Robin Lee Class: D ID Status: None Address: 2619 INDIGO CT Audit#: 6917811 DL Status: VAL Issue Date: 05/03/2013 CDL Status: None City/State: IOWA CITY,IA 522406810 Expiration Date: 10/24/2018 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Melling Address: 2619 INDIGO CT Restrictions: Corrective Lenses Restriction None Date of Birth: 10/24/1964 Supplement: Mailing City/State: IOWA CITY,IA 522406810 Sex: F History Information Accidents-Accident involvement indicated does NOT mean the Individual was at fault or given a citation. Accident Date Case Number JUR 04/15/2009 502913 IA Name:Reyes,Robin Lee DL/ID:284AD4320 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 he set upon this document,at Ankeny,Iowa this date: ueiut� t ' oftcivjt ', 4/9/2014 : IOWA :y's is */ 1,4 etelt rlt4�f�RI1i�A s Office r of Driver Services Iowa Department of Transportation Name:Reyes,Robin Lee OL/ID:284AD4320