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Home My WebLink About14-045 Authorization Number 5 4 k 1 (Office Use Only) 4 —fes®riu • APPLICATION FOR TAXI 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 Middle Last 1. Name V I GTO SZ UG-0 t N P f}(<Gt. -1,�� 2. Mailing Address G�t TG 1 a-1 y,e 3 V. ((e Av-e Yk,ut) I O` to w, 6t4/, /6‘,14 5,4 //,‘ 3. Telephone: Home 5 ` a $ 19 6S Other: 85 - as s - j 9 6 I 4. Prior experience in transportation of passengers: 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 'N 0 Type of offense Where When 6. Have you beeA convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? t_J Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? NAJD Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? t' 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) NC) 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) derWtaxidrivbadg 03/2013 �-1 c �kK -t4 1 ! I hereby certify that I ave i sued t�2 me by the Iowa Department of Transportation a valid Chauffeur's license number \ ___414-&- g+- . 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) I Signature of Applicant - Date bZ 2E7 2°(i ************************************************************************************************************************************************ STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by ') , Li-0,C 1 . . A�1 A,1«�e . On this c:.?f±LI day of d��1�-�� ,7) 9 5 > .. LYtNDY S.Number 72 Nota Public blic hh and for the Sta of lower i Commission Number 729428 ry my t..ommiss n txpres oW 1 -1 le 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). ‘_ 1 I r, _ --c21..-1 q Signatu of Polio: frief 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. jl ,.u�' k • 'z''i' f/ - 4 - Signature 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 1/2" (height)and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerkltaxidrivbadgeapp2010 doc 03/2013 Feb. 28. 2014 11 : 56AM Div of Criminal Investigation No. 4091 P. 6/7 leo. L4• LV14 J:) Iriii t.liy Merit — t.lty 01 Iowa t,ity vu. 44vo r. L • „a. STATE OF IOWA ,,`> fi `?. (Cr tetanal History Recoted Oaeck s'' ' h°a''�� IV .IIDDY e .)t e nil. et.. `higijmu DCI AccountNumber: OD-— • (it-applicable) To: Iowa Division of Criminal Investigation From: City of Iowa City Support Operations let mean,1"Floor City Clerk's Office 21570,7th Street 410 Ts,Washington Street D69 Moin es,Iowa 50319 (815)725.6066 Iowa City, IA 52240 (515)725-6080 Fax vs Phone: 319.356$447 sax: 3193564497 I am requesting an Iowa Criminal History Record Check on: Last Name(mandatory) First Name(mandatory) Middle Name(acommended) ftiCcAKW&-, Tic To (L U6-• 0NK( A Date of Birth enandalory) Gender(mandatory) SociEll Scaul tty Number(recommended) 1 -PIR I L 6th r 1 9 83 , Male °Female 0 f 0 O Lt" Og5a--,. Waiverinformat'inn:Without a signed waiver from thesubjectofthe request,a complete criminal history record may not be releasable,per Code of Iowa,Chapter 6912.Fpr comnlete criminal history record information,as allowed bylaw,always obtain a waiver signature from the subject of the request. Wilber.Relegse:I hereby give permission for the above requesting n o- I. ✓educt on Iowa criminal historyrecord ohcc(c with rho DivisionorCtlnanal Invcsligveon(DCQ. Any alm(nsl history data concerning ma that mai tnai toj o DC'mar()Timed es allowed by law, _ I Waiver Signature: U,I -t�� • o-g_eQ • Iowa Criminal History Record Cheek R.esultt tbctuso only) As of 2.—.9.(9 —74/ ('r a searoh of the provided name and date of blah revealed; �`= r" -•-i 141 0 LT:) :S-, it)-'l N 1.:;: No Iowa Criminal History Record found with DCI c\a —. c • ® Iowa Criminal hstoryRecord attached,DCX#1 _ w = DCIinitials n • • Received Time—Feb. 24. -2014— 3:30PM No, 3615 Page 1 of 1 4 SMARTER I SIMPLER I CUSTOMER DRIVEN VUWW.IoVVBCIOt.go Office of Driver: PO Box 9204 1 Des Moines, IA 50: Phone: 515-244-9124 1800-532-1121 1 Fax:515-: www.iow Certified Abstract of Driving Record Inquiry Date: 2/20/2014 DL/ID It: 780AK7921 (IA) Customer#: 6193704 Name: Akukwe,Victor Ugonna Class: D ID Status: None Address: 36 VALLEY AVE APT 10 Audit#: 7807921 DL Status: VAL Issue Date: 02/19/2014 CDL Status: None City/State: IOWA CITY, IA 52246 Expiration 04/06/2022 CDL Cert Status: None Date: Endorsements: 2 CDL Med Status: None Mailing Address: 36 VALLEY AVE APT 10 Restrictions: NONE Restriction None Date of Birth: 4/6/1983 Supplement: Mailing City/State: IOWA CITY, IA 52246 Sex: PI History Information CLEAR DRIVING RECORD Name: Akukwe, Victor Ugonna DL/ID: 780AK7921 Pursuant to Iowa Code §321.10, I, Klm Snook, Director of Office of Driver Services, Iowa Department of Transportation, do here 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 offic currently In the custody of said office, and that I have been authorized by the Director of the Iowa Department of Transportal certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa thi! /^o$t.- �...%ii, 2/20/2014 'rr IOWAy', D. 0. T. 141 =4 eidenik ::� 4 iF ,:" Office of Driver Services I4'f OBIVtN„att., Iowa Department of Transportation Name: Akukwe,Victor Ugonna DL/ID: 780AK7921 2/20/2014