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Home My WebLink About14-041 Authorization Number / r 1 (Office Use Only) IIIA tL i 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 ast 1. Name fY1 S V A c-1. LL___ I 2. Mailing Address O j\ roc) R R Rt clS 1-4 3. Telephone: Home -) -1 3 Ln 1 Other: \ 4. Prior experience in transportation of passengers: .2) S 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? I'o O 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? 1\� Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 1ktc_..)A (Th �P� *64—t moo , aoa� 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? v 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) '� c 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 03/2013 I hereby certi that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number BbPP `z)Y . I understand that if I falsely answer any questions in this application, that this a ation 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) Signature of Applicant Date Z 2 7- I STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me byJ b vut_ 5 , )'4Aci a - t . On this c2 -t - day of I • *At WENDY S.MAYER •428 Notary Public i d for the State owa .My Comm •n spires ow • \---5-1 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 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). 2/.201/ ignature of Police 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. )7 Signatu _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 der)taxidrivbadgeapp2010.doc 03/2013 0-532-1121 I ow a Q p a[ 4 a (C 1 Free) 515-244-9124 la� F,4X:575-239-137 fl office el Driver esheIA g3p�Er9211d p0 Sox 924f. Certified Abstract of Driving Record 2613054 customer#: None 808W5014(IA) ID Status: VAL 131../ID#: p Df-Status: None 12/4/2013 Class: g705162 CDt— Status: None 09/28/2010 131— tat Status: inquiry Date; lames Ray Audit#' None Kendall, 0R NE 12/09/2014 CDS— Med Status: None Name: Issue Date:Date: 2051 BIROHY'DOOD Expiration Restriction Address: 3 5 1ppleme°t' RAPIDS,IA 524022813 Endorsements: NONE CEDAR RA 12/9/1944 city/State: Restrictions: 2051 BIRCHW000 DR NE pate of Birth: N Mailing Address: sex: CEDAR RAPIDS,IA 524022813 Mailing City/State: History Information county )I Exptana8on Benton p ACD speed Convictions Date _ s92 Conviction Citation Date 08/05/2009 01/25/2009 the custodian of th certify that I am a reco 5014 da hereby by the= Direct Transportation, that 1 have been authorized DL/Ip,808W lows Department c of said office,and Name:Kendall,lames Ray a custody Driver SeMcos� currently in[h 321.10,1,Kim Snook,Director of Office o an of8dal record Code 4 this c a true and accurate copy Iowa this date: nt to Iowa that document,at Ankeny, Office of Driver Services, so certify he sot upon this Office Transportation I have caused to the Department to Department of the seal of In witness whereof'I have my signature and _=p hitt pjd�yfl 12/4/2013 y� ;D.0.T. a< Driver servcs M .. 'S�g ot0ce°e artmen[otiter ansPnrta[lon ygit URIIt.�` towa D P Name:Kendall,Dames Ray DL/ID'808W5014 (C4- ga151 l • a��; ''i em�a STATE OF IOWA �� ; 'ow, Criminal History Record Check -O� ••, ,e A-r_, s • °'F • .� Request Form ir"rimar,�oAk T/OI.: p� • • DCI Account Number: 9861-F. . (if applicable) To: Iowa Division of Criminal Investigation - ' From: City Clerk's Office Support Operations Burean,1' Floor 215 E.711'Street City of Cedar Rapids . 101 First Street SE Des Moines,Iowa 50319 - Cedar Rapids,IA 52401 (515)725-6066 (515)725-6080 Fax . ' Phone: 319-286-5060 Fax:. 319-286-5130 • I am requesting an Iowa Criminal IBstory Record Check on: Last Nance (mandatory) • • First Name(mandatory) Middle Name(mandatory) • ' Date of Birth(mandatory) • . Gender(mandatory) Social Security Number(mandatory) ;').VD-7 6 et- t.l`t.- ' =Male Dr'emale L(.7 S to ei ci,,:. 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 froth the subject of the request Waiver Release:Ihereby give permission for the nbove requesting official to conduct an Iowa criminal history retard checicwith the Division of Criminal • Investigation(DCI)• Any criminal history data concerning me that is maintained by the DCI may bereleasedas allowed by law. Waiver Signature, • ar v.�— C r -<2..�-s—`-12- Date ta"0lf . 13 • Iowa Criminal History Record Check Results (DCI use only) As of • .. • , a search of the provided name and ante of birth revealed: ❑ No Iowa Criminal History Record found with DCI - • . •• • : 0 Iowa Criminal History Record attached, DCI# . DCI initials DCI-77 (08/25/10) e.n fTh rm1-7 Li---1.a — I ") - 2_ETD 15 • SING Page 1 of 1 Single Contact License & Background Check Results Criminal Histo Background Check Last Name Other Last First Name DOB SSN Name Selection Kendall James 1944-December-09 483506097 Criteria Results Further research is.required. Please await DCI's final response for criminal history. Please note: There may be multiple individuals with similar search criteria, requiring more research. Background Check Complete As Of 12/5/2013 9:22:09 AM NOTE: The first and last names, date of birth, and SSN displayed in the abuse registry and criminal history results are just as they were entered on the screen, Billing Account 9861-F Cash Deposit Currently at$619.00 Generate PDF SearehAgam *t • httns://www.iowaonline.state.ia.us/SING/SINGSOLProcess.aspx 12/5/2013 ' — ue C. 7. LV I) 7.L`thlYI in )/ UI vt lilt In61 Inv e0l l gal I U II IYU, 'IV 71 Page I of 1 Submitted 2013-12-05 09:22:02.727 :fir mak, IOWA RECORD CHECK REQUEST ,. to lot FORM S 1r' 41 , , ACCOUNT NUMBER:9861-F To: Iowa Division of Criminal CITY CLERK-CITY OF Investigation From: CEDAR RAPIDS Bureau of Identification 3851 RIVER RIDGE DRIVE NE 215 E, 7th Street 52402 RAPIDS ,IA 52402 Des Moines,IA 50319 (515)725-6066 Phone 319-286-5060 (515)725-6080 (fax) - Fax 319-286-5130 . Contact Preference: F REQUEST (* indicates a required field) I m re. estin_ an 10 , • It .: tjTS7 onv record check on: KENDALL, JAMES RAY Last name* First name Middle name NO Maiden/Other Last name Volunteer 12/9/1944 DLI. 483506097 • Date of Births Gender* Social Security number* (DC1 use only) RESULTS " As of 12/9/2013 9:21:43 AM,a name and date of birth check revealed: Cell Record Attached DCI# No CCH Record Found_X DCI initials 46 Waiver on rile ves I hereby give permission for the above requesting official to conduct an Iowa criminal history record check with the Division of Criminal Investigation,Any information maintained by the DCI may be released as allowed by law. Received Time Dec. 9. 2013 9:20AM No. 3600