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Home My WebLink About14-033 Authorization Number ) - .3.� i r 1 (Office Use Only) 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 l Lst e 1. Name �� Wj /4/(U.- t /t 2. Mailing Address ?Cr) sd � � (04= lih k, • 22.�1( — -- C 3. Telephone: Home(r3l e0 3 74)----(-Y6 Other: 4. Prior experience in transportation of passengers: cg 7.6 GQ(tut<-t- Cay 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 1,1C-) 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? v\O Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? VIC) Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? no 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) derMaxidrivbadg 03/2013 A Pi 1 hereb ecrtt,-that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number - ---,- oda bJ:1)02- 6 understand that if I falsely answer any questions in this application, that this a*'alication may be denied. I understand that if I falsely answer any of the questions in this application, that this application will b- 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) " q Signature of Applicant t ��U Date/2124.j%/ / V. STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me bya - a . _ a. . . . On this c9 C ±fk day of r�a(\,1..ca1c 1 f — �IVEN0 s.MAr 72 til ,:- -I .�. • ni inner 729428 Notary •Public and for the State o owa _, . My comms sion %res sow ********* ******************************************************************************************************************************* 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). _-- )r4/6..------- .,.x7720/// Signature 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. 77') 2.- -,,--"Ji- .tc. /:, -.?s--- ' ' 1 Signature o(-City Clerk or designeeS� Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 81/2" (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 Gerkttaxidrivbadgeapp2010.doc 03/2013 c4 www.iowadot.gov SMARTER I SIMPLER I CUSTOMER DRIVEN Office of Driver Services PO Box 9204 I Des Moines, IA 50306-9204 Phone:515-244-91241800-532-1121 I Fax:515-239-1837 wvntiawadof.gov Certified Abstract of Driving Record Inquiry Date: 2/20/2014 DL/ID #: 302882858 (IA) Customer#: 1808601 Name: Calloway,James Michael Class: B ID Status: None Address: 2110 N DUBUQUE ST Audit#: 4986660 DL Status: VAL Issue Date: 02/03/2011 CDL Status: VAL City/State: IOWA CITY, IA 522451624 Expiration Date: 01/20/2016 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 2110 N DUBUQUE ST Restrictions: NONE Restriction None Date of Birth: 1/20/1968 Supplement: Mailing City/State: IOWA CITY, IA 522451624 Sex: M History Information Accidents -Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 08/08/2013 754691 IA Name: Calloway,James Michael DL/ID: 302882858 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: th Ot.•• .744 y\ 2/20/2014 a :` IOWA �1, fo: ia0 i 1eteera iii4:Of;;AICA sd- Office of Driver Services ` nif,"I t„-- Iowa Department of Transportation Name: Calloway,James Michael DL/ID: 302882858 , ostiJan. 27. 2014: 11 :23AM Div of Criminal Investigation -, DCI 1om,No. 7686 P. 3/3 t9 ►-ao-it • STATE OF IOWA Criminal History Record Check0 Request Form DC Account Nwnber: 'i3g3-Fc- .. ��A �-r— (ifrppik4Ie) Tet lows Division ofCriminNmvestIgat1oa From: rr.AYG5 1 0.xl Sappon Operations Bursa,1^Finer 14 5 y e nes Or. 215 7 Street 1 Der Moine. Iowa 50319 to Gkj, I A 'a-. i D • (516)72'56066 'fait( 515)725.6080 Fee Mum (,t ") 339- • Fart• . 1919 351-8a11 _ I am requesting an lows Criminal History Record Check on: _ • Middle Name(recd a..dod) Last Name(mmdrtmry) First Name(madatoM — Ca1( 15 GA4htJ • 0:4A nastl — Date of Birth owesGender(mandatory) Social Security Number eeeemmot k. — 2o - 67Y le aFemale X62' ?Cr 12 al/ Waiver Informafon:Without a signed waiver from the rubJeet of the request,a complete eriminat history record may not be releasable,per Cods of Iowa,Chapter 691.2.For tomnlett criminal history record information,as snowed by law,stwaya • oblate a waIver stanolure from the abject of the request, Waiver Release:I lowly gWve peedv ..1r the above r[quatb{osrkW to conduct.n Ion edme.l khan retard check with the Dirtilwofedam' rnvagipibn(DC7). Any edmin.l history data ' Ing m.gat le Inti. M the xi nu tit tel u JlewWed kW. • WaiveiSlgnature: �9 I J Iowa ret , a ,A. . 1 .a ' ecord hec Resul r (DCI use only) As of (-TT-I 1 ,a search of the provided name and date of birth revealed: r r u e_ , ri —n D No Iowa Criminal History Record found with ICI c/i ro t� • cis= -b Cern 0 Iowa Criminal History Record attached,DCI H -i j'¢ o O� r v DCI initials__. N DCI-77(0s/2.5/10) Received Time Jan. 17. 2014 9:59PM No. 7046