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Home My WebLink About14-021 Authorization Number gEl l —PZ � 1 (Office Use Only) fes. 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 1f -\ Middle (( Last 1. Name ,( fit JJ lon (' > . �7 2. Mailing Address qO H-u� L + j( j 1=0)4_ - 3. Telephone: Home 1) - 9 36 �� `� Other: /I 4. Prior experience in transportation of passengers: (ciid'S ck,\1N'y fk- Jl��i (lab b 0P .1c:w C16 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? !fit: 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? f\J Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? !UC 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) clerMaxidrivbadg 03/2013 I hereby certify th t I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 1<-A-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 tins 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 ri I Date /, 9 pp I, ��Z�� 7` STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by {vl 1 6A,_c:LA., ice. A- - _,2. . On this oV-QA -tLA,_ day of 7avtu mss. ( 01It 1 D3-` - 5 1Lk tr%r'v,� WENDY S.MAYER Notary Public in for the State of IJP i Lommiission Number 729428 o4w • MYY 'ssa pyres 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). (2df _P.1(Signatof Polic- ef 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. /2 �—z . k _ ..,-(..-vi /— ,19 _r`') Signatur 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 derk/laxidrivbadgeapp2010.doc 03/2013 ; Jan- 14 2014 3'36PM Div of Criminal Investigation (FAX)319330z7N0. 6709 P. •1�2ooz , .roY/._. 2E. .-. ..... Cab tL,, -. ., r ' ■ STATE OF IOWA 'Us`, ',, � ' �. `\= Ciminal History Record Check 1 - ...112,.;:,,,,,,t..9-, Request Form • . , t tP w DCI Account Nurnberg 9967-F • (lreppliceblc) t To; Iowa Division of Criminal investigation From: Yellow Cab of Iowa City Support Operations Bureau,1°Floor P.O.Box 428 21s E.7h Street Du Moines.Iowa 60310 Iowa City,IA. 52244 . (515)725-6066 • (515)725-6080 Fax • (319)3384771 ' -. .. . .. .... �.�--, ..._ --^Phone:• .n.._ _-• ... . _ Fax: ^(319)339-7302 • I am rocas ling on Iowa Criminal IdistorxRecord Check one • ' Last Name(msnduoy) First Name(mutddottt' Middle Name(reccmmended) Date of Firth(mandatory) Gender(mandatory) • • , 'SoclaI•$ccurlti Number(i ammcndod) `3�\ CA (o$ ., Vlale • ['Female di -DZ.-s037 Waiver Information:Without a signed waiver from the object of the request;a compete criminal history record may not bo releasable,per Code of Iowa,Chapter 692.2.For compietq criminal history-record Information,a allowed by law,airlaye obtain a waiver signature from the subject of the request. . • Waiver Release;Iharaby give paminlon for ata abovenaaocning Wald to landed on Iowa cdmiwl Wear rand check with the DLu(on of Criminal lane.ugadon(CC9•Any aiming history data conean:ne tha`t�rsmaNWnedbytraw _... . ..._� — - Waiver Signature; f x . • Iowa Criminal�� History Record Check Results • (DCI use only) Aa of /—At--6:70/3<a march of the provided name and date of birth revealed: �•!'� — r i ❑ No Iowa Criminal History•Recor'd found with DCI 14 u»i - ter. /4W 'iW41t` Iowa Criminal History Record attached,Dcl# /777 • G▪i:zs .a -.I 7 '4 a s 5 DCIilrifials r' N • DCI-77(08/25110) Received Time Jan, 10, 2014 9:28AM No, 6429 a 'Jan. 14. 2014 3: 36PM Div of Criminal Investigation No. 6709 P. 2/2 IOWA CRIMINAL HISTORY DCI 00494587 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED- 2014/01/14 DCI:00494587 NAME, HOPE,NICHAEL GLENN DOB SEX RAC HOT WGT EYE HAIR SRN POB 19680306 M W 602 320 BLU SRO FAR IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19950207 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401-3 POSSESSION SCHEDULE I-MARIJUANA TRK#: 014615001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA TRK#: 014615801 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950707 PROBATION 1Y 19950707 COMMUNITY SERVICE 100H 19950707 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 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 f Iowa Department of Transportation �Ie, Office of Driver Services (Toll Free)800-532-1121 PC)Box 9204,Des Moines, IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/28/2014 DL/ID#: 155AC4503(IA) Customer#: 3239199 Name: Hope,Michael Glenn Class: D ID Status: None Address: 69 HOLIDAY LODGE RD Audit#: 5921249 DL Status: VAL Issue Date: 04/13/2012 CDL Status: None City/State: NORTH LIBERTY,IA Expiration 03/06/2014 CDL Cert Status: None 523179516 Date: Endorsements: 3 CDL Med Status: None Mailing Address: 69 HOLIDAY LODGE RD Restrictions: Corrective Lenses Restriction None Date of Birth: 3/6/1968 Supplement: Mailing City/State: NORTH LIBERTY,IA Sex: M 523179516 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 06/17/2012 07/18/2012 592 Speed Johnson IA 03/28/2013 05/12/2013 592 Speed Johnson IA Accidents-Accident involvement Indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 03/17/2012 677633 IA Name:Hope, Michael Glenn DL/ID: 155AC4503 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: 4\�� .r,..•HIEIE';7%." 1/28/2014 ?a= IOWA. oy a eLezard Sr,.8 . * Office of Driver Services hr`•a„A A—'-- Iowa Department of Transportation Name: Hope,Michael Glenn DL/ID: 155AC4503