The URL can be used to link to this page

Home My WebLink About14-018 Authorization Number ) 9 - ) 6 -b _ 1 (Office Use Only) ��.®14 iiiiitil III 114 ON UV 1111117 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 iq rut E s Middle � 4/ Y Last /(.1i/ 7 ._-.- 1)-'- r Name 2. Mailing Address C9 2 ;2,3 guy 7 E /f ��I ;y ,Cj �fF t�` N N �"c_ > C f/�ccrt - JCr'C 3. Telephone: Home . 'G :_?= }>>.Z < G'./ Other 4. Prior experience in transportation of passengers: /�` 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? - Type of offense Where When 6. Have you bepgn convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? L" ) Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? A) 0 Type of offense Where When 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? A v 0 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) clerk/taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license riumber g 3 ?f C L 1-445b . 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) J + Signature of Applicant _y..-p,�-�A4‘/(/6/1 Date STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by n!u p5 E. . tit/ )I " t_,1- . On this 0-9 -U.-t day of T5b.vi it A. -i r\A ?vl.y =`d ,. e Dail s Notary Public in ant'or the tate of Iowa r 30 > Commtssl0n NS MAYER My Comm, ,ssioer 729428 ...... .**.***** . •*. -s.. ...*..****.**************.******.****...*******.**************************...*.........******.******... 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). if .�wf/ f -a''/_Jq Signa re of Poll'e ' hief 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. . .-'-01 1 L,- - - . J - )--t-1 -.1 Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/2" (width) and 51/2" (height)and prominently displayed to all passengers. ................................,..**.*................**........*...............*........*.....*............*..........................*....*.. Office Use Only Approved application DCI report State certified driving record Website update clerk/taxidrivbadgeapp2010.doc 03/2013 4 IN Iowa Department of Transportation Free Ofiof Driver Services PO Box 9204,Des Maines IA 50306-9204 )800-To1121 11111. FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/24/2014 DL/ID#: 239CC4258 (IA) Customer#: 1130919 Name: Miller,James Richard Class: D ID Status: None Address: 0223 Garfield Avenue Audit#: 7680017 DL Status: VAL Issue Date: 01/08/2014 CDL Status: None City/State: Mechanicsville, IA 52306 Expiration Date: 01/17/2016 CDL Cert Status: None Endorsements: 1L CDL Med Status: None Mailing Address: 0223 Garfield Avenue Restrictions: Left and Right Outside Restriction None Mirrors Supplement: Date of Birth: 1/17/1931 Mailing City/State: Mechanicsville, IA 52306 Sex: M History Information Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident DateCase Number JUR 03/09/2013 .._ . _..._..___ _. ........_.... ..._.__ _. ...�...__-1730021._._._,._...,_�.._._ _..—............... ..—.._...____� _..._--11A .....__..�_ .. ......_.1 Name: Miller,James Richard DL/ID: 239CC4258 II Pursuant to Iowa Code 4321.10, 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: vyy 3,`t.— .P$% 1/24/2014 i ';c ''.wat � a't s 1104. t Iowa Department Office of Driver eoflTransportation Name: Miller,lames Richard DL/ID: 239CC4258 (LXJ `. 1-)G -LA- GUI (--1 - co a� �,-•• s,' STATE OF IOWA. _i_.., . • , 1, Criminal Historyc Record Check `z� lRequest Form ' B`%.i,in `"FCT06PLS iii „{i, DCI Account Number: 9861-F. (if applicable) Ta: Iowa Division of Criminal Investigation From: City Clerk's Office Support Operations Bureau,1st Floor 215 E.7th 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 History Record Check on: Last Name/ f/ (mandatory) • - First Name(mandatory) Middle N e(mandatory) • /./. 7 (-••4.'Ai c, cz y Date of Birtb(msmriatory) . Gender(mandatory) Social Security Number(mandatory) /7 � Male ❑Female 6 545L.. . . 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 from the subject of the request. Waiver Release:I hereby give pr-vnission for the above requesting official to conduct an Io. •criminal history record check with the Division of Criminal Investigation(DCI). Any criminal history data c• c. .g me that is maintained by the Doi may released as allowed by law. j /24/ Waiver Signature: , / • Date. • e' / f • _. Iowa Criminal History Record Check Results (DCI use only) As of , a search of the provided name and date of birth revealed: r • 0 No Iowa Criminal History Record found with DCI 0 Iowa CriminalHistory Record attached, DCI# . DCI initials DCI-77(08/25/10) fir:400 111 SUNU rage I in i i Single Contact License & Background Check \ Results - Criminal History Background Check Last Name Other Last First Name DOB SSN Name Selection Miller James 1931-January-17 480441943 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 1/9/2014 10:13:35,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$1599.00 Generate PDF Search Agala https://www.iowaonline.state.ia.us/SING/SINGSQLProcess.aspx 1/9/2014 Single Contact License & Background Check SING ID DCI031 Database codes are: CRM Criminal History DAR Dependent Adult Abuse Registry SEX Sex Offender CHI Child Abuse Registry AID Nurse Aid Registry NUR Nurses Records Matching Last Name Miller And DOB'01-17-1931' EVENT LAST OTHER FIRST LICENSE DATABASE FINAL TIMESTAMP NAME LAST NAME SSN NUMBER DOB CODE RESULTS STATUS RESULT 1/9/2014 ***** CASH_DEPOSIT SET 10:13:05 AM NTiller James 1943 01-17-1931 TO 1599.00 1/9/2014 Completed 01- No CCH Miller James *****1943 01-17-1931 CRM Further Research Record 10:13:05 AM 13-2014 Found 1/9/2014 CHARGE$15.00 10:13:05 AM f