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Home My WebLink About14-012 Authorization Number )tif 1 (Office Use Only) MINI an ligqr CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (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 Fi t Niddle Last 1. Name M10A/1- 2. q f{._ { 2. Mailing Address t 4 (I� �' �P�� / 4'O w ut t I /11;4- 5 7 (4 (9 3. Telephone: Home - !9 Y3 0 I I Other: 4. Prior experience in transportation of passengers: F`1 QV? 1 C PA/Y) f I y i 0 P I U 5 yQ�( 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Yp 5 Type of offense Where When (i)w COralVI' t( i$4 . -U1)/ 'POO 1'7)55mq-4(1 M.01r1 LQ/'c 7 6ot(itY1 t/4 ✓11 G4! 2(/C/ 6. Have you be n convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? 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? 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) cler1 taxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 2 0 9 / Z 7'S2 . I understand that if I falsely answer any questions in this application, that this application maybe 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) f / Signature of Applicant / lir Date l ************************************************************************************************************************************************ STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by i'[a)- t ) r_� )- tl r rdch . On this I Li tL day of �,c,,A\ cx-c aDL� Notary Public i .nd for the State of?wa Sa�i vJEM9Y 9.MAvcn _ N, Co MCom Number 729428 Piret. • Myy Commis n_E p�lret 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). /—/Z — � Signature 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. NSignat 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 clerldtaxidrivbadgeapp2010.doe 03/2013 i De'c. 26. 2013 3: 17PM Div of Criminal Investigation No. 9255 LP. 1/3 w,:w. LV. LVID IG• LUI nl blLy VII bl Lr UI LUtl6 VIIY ,No.'1110 r. • , - I. 'd„';'s,••11yg, . STATE OE IOWA '% , ti1.,F1 e! , . 1:1 ((l rc Ij innh 11 �! i1MY,ii r ig r�'rs• r•,( n IIAIJ[�isEol Recur Check :t- ��vs;.� ar:��:: i et..„ Fenn I y''o L;.: v - ' 111LIh `.4 Jldegtxest d O 'Yll i 4J1iAiC1 u tiV ;1 DCI Account Number: • r R/pikdtle) To: loWil DiwilohofCriminal!RVeetff(nlion 17ro)nl GMTV OF TOTYA CITY Support Operalloudllurenv,1"Moo( CZTt masts ot+pICit 215E,7nStreot 410 U. WASHINGTON STREET- ' baa Whiner,Iowa S0319 . (515)1296066 • IOWA CITY IOWA 52240 (515)12S17n ' Phonal 919 95b-5041 , Wiwi 910�aS6-5447 I nm rayuosting An Iowa Criminal Hlsso Record Mak on; Last Mang(ntandAloN) Fiat Name(mendAIory) All aa1O Nnute(reeommendcd) • it0 1 ib M<affiti?Is/ kYai Ditto ofnirth(mfQadelw{oly) Gender(mendmory) Sootnl Soo)rh•itV NWnber(reeorRmended) ( 0/ 1 I�I/ 0 iIMn1e ' Uremale Witival'.1r11formaaop,WithoutaRlgnodtvntver*ontIhosubjectof(horegneef,acompfoloo1'itnlnnlhistoryrecordmaynot ho rolaodnble)per Code WWTowa,Mop ter 6912.1ror comploteark lhial history rccoril lnrormnlion,Al nI)owda bylaw,always • obtain Rivers')Willie f-om the sub odor thon.,100 L. Walvet'Yfefeare;t'way dopermbdonAeLhaelan requeprnrWOO Ioyo gac{tieToirRcdmlmlAnmlyreco/AcheckwihlhaDidsIonoferiminei rnvgigetrontnCQ.Myq(a;hal Algot data concerning no that Hm. •1 J6q the,Urney 6o rebased asn11o1redhylASY. Waiver Signature; Iff] Alt4.Lk _ _,.• ..-...,/ ; , 51 l 1 4 Iowa Cr#mihal History Record Chock JResnYts . ' roenne oh') As of \*Xp C.A ,a search of Ilse provided name and date ofbitihaevealed: ' • 0 Igo Town Criminal I istory Record found with DCI (03 Towa C rlmIiinl IllatoryRecord attached,DCI ii 1 $lip 54 a--- • bClinitials bel-71(08/25/10)• • .., Received Time Dec, 20. 2013 12:28PM No. 8917 De'c. 26. 2013 3: 18PM Div of Criminal Investigation No, 9255 P. 2/3 IOWA CRIMINAL HISTORY DCI 00786342 • MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/12/26 DCI:00786342 NAME: HOLIDA,NATTHEW RYAN DOB SEX RAC HGT WGT EYE HAIR SRN POE 19861031 M W 600 300 GRN PLN FAR NC ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD xtf` 01 ARRESTED 20060924 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA713-6A BURGLARY 3RD DEGREE TRK$: 101985701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 TA STATUTE IA713.6A(1) BURGLARY 3RD DEGREE COURT CASE ID: 06521 FECR077331 CHARGE CLASS: NON CONVICTION TRK#: 101985701 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20061208 PINE $750 20061208 PROBATION 2Y 20061208 DISCHARGED PROM 20071217 DEFERRED JUDGEMENT 02 ARRESTED 20000505 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: 1A0043M01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCR083297 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A0043M01 LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 20080925 03 ARRESTED 20000718 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321J.2 (A) OPER VER WH INT (OWI) / 1ST OFP TRK#: 1A004N301 ' 'Dec. 26. 2013 3: 18PM Div of Criminal Investigation No. 9255 P. 3/3 • DCI 00786342 PAGE 2 OF 2 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VEH NH INT (OW1) / 1ST OFF COURT CASE ID: 06521 0WCR084026 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A004N301 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT JAIL 2D 20080925 FINE $1250 20080925 12 HR OWI COURSE OR 20080925 OWI WEEKEND PRG AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OP CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON-LAW ENFORCEMENT AG�=ESI BY THE DCI. IN THE ABSENCE NGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT TH£ RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION dr. Iowa Department of Transportation , Office of Driver Services (loll i ree)800 53 -1121 iiNO Box 9204.Des Manes. LA 503069204 515-2 -9124 NIIIIP !-AX 51523 183? Certified Abstract of Driving Record inquiry nate: 1/1S/LU14 UL/IL/ #: 7V7AAL/SL WA) i,usLomer#: 47u3Lb7 Name: Halide, Matthew Class: D ID Status: EXP Ryan Address: 1417 W BENTON ST Audit#: 7097605 DL Status: VAL Issue Date: 07/03/2013 CDL Status: None ucy/state: IOWA LII Y, iH expiration uace: iU/31/Lu 14 wL Lert status: wone 522464902 Endorsements: 3 CDL Med Status: None Mailing Address: 1417 W BENTON ST Restrictions: Corrective Lenses Restriction None Supplement: {idle UI ii/fill: LU/JL/Lvoo Mailing IOWA CITY, IA Sex: M City/State: 522464902 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 05/05/2008 09/25/2008 A33 Drua/Drua Related Johnson IA Conviction 07/15/2008 09/25/2008 A20 Operating While Johnson IA Intoxicated Operating While lntoxicatea l est Recusal/ l est Failure violations Occurance ACD Explanation JUR 07/15/2008 A98 OWI Test Failure IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked 07/26/2008 01/21/2009 A98 OWI Test Failure IA IA Name: riolida, Mattnew Ryan UL/1U; SU9AAL/ L 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