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Home My WebLink About14-024 Authorization Number •0 1 (Office Use Only) aluTiphit , ► III s` -4 WHIT 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 �g� r Mid 1 st 1. Name / 2. Mailing Address 9 174e? 990 t-/-77 3. Telephone: Home th�r: 5 6 ,) 4. Prior experience in transportation of passengers: rQL -iry / .L/ �/1�J — / ? oacs P S / A) CO') 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? C/ e J Type of offense Where / C � W,hen f() SY ) /62'1) Cv >1)/19a(41 -i,&fir" - fid Z/ 7 j �l 1 f � 4�� ar r j )c1-73.14' 9' ?L Thr" i/ A- �/j-� J�� U� f� y��w uul 6. Have you been convicted dot-Operating a motor vehicle while'Gnder the influence of alc`dhol or drug's in the last five ' 7 9 / years? 7/C) Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? X/J Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 4/6 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) 4/0 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) clerkitaxidrivbadg 03/2013 I herebycertify that I have is§ug to me by the Iowa Department of Transportation a valid Chauffeur's license riumber • � �S—A 4 S £/ 6 c . 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) / • Signature of Applicant , �� Date c',4 0 ( STATE OF IOWA COUNTY OF JOHNSON ) Subpefibgd and sworn to /ore me by J� " ' 1 roc"< On this J day of i"Lf.l tip04,s KELLIE K.TUTTLE Nota Public in and for the State of Iowa „i—wim pr 721819 Notary �7A 1My Com issio Expires f �C7 Cil 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). bc3 2/1//// 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. igna re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 Y2"(width)and 51/z" (height)and prominently displayed to all passengers. ************************************************************************************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update clerkftaxidrivbadgeapp2010.doc 03/2013 Page 1 of 1 Orcitik Iowa Department of Transportation Office of Driver Services (Toll Free)80D-532-1121 PO Box 9204,Des Moines,IA 50395-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 2/5/2014 DL/ID #: 435AA5012 (IA) Customer#: 224854 Name: Shrock, Steven Warner Class: D ID Status: None Address: 4487 490TH ST SE Audit#: 6581207 DL Status: VAL Issue Date: 01/02/2013 CDL Status: None City/State: IOWA CITY, IA Expiration 01/17/2018 CDL Cert None 522408288 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: 4487 490TH ST SE Restrictions: NONE Restriction None Date of Birth: 1/17/1946 Supplement: Mailing City/State: IOWA CITY, IA Sex: M 522408288 History Information Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 02/17/2012 673587 IA Name: Shrock, Steven Warner DL/ID: 435AA5012 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: enITIINN =AL it .%i� 2/5/2014 M: IOWA so: io y� D. O. T.,a/�� %. ��f OBIVEAst�" Iowaces aDepartment of Driver eofiTransportation Name: Shrock, Steven Warner DL/ID:435AA5012 2/5/2014 �Nov:Jan. 29. 20148 1 : 15PM;ab div of Criminal Investigation (pnX)31933627cNo, 8016 P. 1/3002 SUM. . • i II.. , • ■:■ . STATE OF IOWA .,,....)42-2`1!::•< vt,t ,,nE i,; Criminal History Record Check 1 • c1�*� IV,ji Request Form ' • rtJ" . �•,. a ;•.14.1 DCX Account Number._9967-F • (If applicable) To: Iowa Division of Criminal Investigation Fromt Yellow Cab of Iowa City • Support Operation,Bureau, l"Floor P,O.Box 428 215 L 7th Street Der lviolnes,Iowa 50319 Iowa City,IA. 52244 , (515)725-6066 (515)7254080 Fax (319)338.9777 . ' ' Phone: ' Fexr (319)339-7302 I am requesting an Iowa Criminal History Record Check on: • LBO Nam 0(mandatory) First Name(mendaiowy. Middle Name(retommended) • R ilUri Ste l W. A . R ' Date of Birth(mendn e,y�)+ Gender(mandatory) 'Social Security Number(recommended) I ""/? 'Ma Ie ❑Female ! g,— -O2I Waiverlf(Jormalionr Without a signed waiver from the subject of the requogt,a complete criminal htatory record may not be releasable,per Cade of Iowa,Chapter 692,2.For comnictg criminal history-record Informatlon,,aa allowed by law,always obtain a waiver alltjaturo from the lulled of the request, • • ' Waiver Release:thereby give pennlssion far the above opening official to conduct an Iowa criminal binary record check with the Dlvhlon of Criminal lnweeugatton(DCO. My atm:noi hlswy data concerning mount.is meinnincd by the DCI may bereleasedas ono ell by law. _ • Waiver Signature: _9 ihIA/ML , ' • Iowa Criminal History Record Check Results • (DClure only) As of I--(..-ti�1 y , a search of the provided name and date of birth revealed: • `-,'' c;, <•• - rn o = =7i rrt ❑ No Iowa Criminal HistoryRecord found with DCI --1 c, Na :tic c, :tic G -ou —r'1 • A4 s Iowa Criminal History Record attaohed,DCI itI cb5k 5 t- zE DCI initials 1�' • 1 ' DCI-77 (08/25/10) Received Time Jan. 23. 2014 11 : 58AM No. 7432 Jan. 29. 2014 1 : 15PM Div of Criminal Investigation No. 8016 P. 2/3 IOWA CRIMINAL HISTORY DCI 00186530 FELONY CONVICTION PAGE 1 OF 2 DATE PRINTED- 2014/01/29 OCI:00186530 NAME: SNROCK,STEVE SHROCK,STEVEN WARNER DOB SEX RAC HGT WGT EYE HAIR SKN POE 19460117 M W 508 180 GRN BRO MED IA ADDITIONAL IDENTIFIERS SC L CHK CCH RECORD *4* 01 ARRESTED 19721124 AGENCY: IA0770000 POLK CO SO CHARGE NO- 01 DANGEROUS'DRUGS/POSSESSION OF CONTROLLED SUBSTANCE TRIO: L07373601 COURT DISPOSITION AGENCY: SA077015J POLK CO DIST COURT COUNT N0, 01 DANGEROUS DRUGS/ POSSESSION/CONTROLLED SUBSTANCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L07373601 SENTENCE PLEAD GUILTY JAIL 180D 02 ARRESTED 19740430 AGENCY: 1A0070300 WATERLOO PD CHARGE NO- 01 IA STATUTE IA204-401 DANGEROUS DRUGS/POSSESSION/CONTROLLED SUB/INTENT TO DELIVER TRK#: L09373701 COURT DISPOSITION AGENCY: IA007015J BLACK HAWK CO DIST COURT COUNT NO- 01 POSSESSION/CONTROLLED SUBSTANCE WITH INTENT TO DELIVER CHARGE CLASS: FELONY CONVICTION TRK#+ L07373701 • SENTENCE DISP EFF DAT SUSPENDED PRISON 5Y 19751025 PROBATION 19751025 03 ARRESTED 19900722 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA236-12-2 ASSAULT/CAUSING INJURY/ DOMESTIC ABUSE TRK#; L07373801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA236-12-2 ASSAULT CAUSING INJURY Jan. 29. 2014 1 : 16PM Div of Criminal Investigation No. 8016 P. 3/3 DCI 00186930 PAGE 2 OF 2 CHARGE CLASS: MISDEMEANOR CONVICTION • TRK$: L07373801 SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT PROBATION 1Y 19901212 SUSPENDED 30D 19901212 EATTERER'S EDU FROG 19901212 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS 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 DCX. 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 • I ,ib