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Home My WebLink About14-011 '2:" - I I Authorization Number f � k 1 (Office Use Only) APPLICATION FOR TAXI DRIVER CITY OF IOWA CITY (Police Department review must be made 410 East Washington strcct between 8 a.m.to 3 p.m., Monday-Friday.) Iowa City, Iowa 52240-1326 (319) 356-5040 (319) 356-5497 FAX arriStil -- ��l�e� � Last 1. Name CI t'V C� ✓ *fit7 t 2. Mailing Address $ v l A-Nt -e✓t• C A r1 �e ! vn d 3. Telephone: Home '3/7 6.3 0 /q Other: 1 2- 1 2 0 Z I 4. Prior experience in transportation of passengers: Z> - a✓ _ (.// //0 Lt./ c ct ?- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Ye....; Type of offense Where When �� " { (SSP firgil0r2 �—vlf/c* 2_ oc.3C� 6. Have you e _convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where When r 7. Have you been convicted of any traffic offenses in the last five years? 'P5 Type of offense Where When _p -eJ i f ---C)Lt-)CSI 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? s7/1....) Type of offense Where When 9. Have you uuJever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) / ( 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) ..3.;:,,77,.bacq 03/2013 I hereby certifythat,I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number ij 60 3 . 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 Applica Date /A//1/ ***********************##*********************************************************************************************************************** STATE OF IOWA COUNTY OF JOHNSON ) Subscribed and sworn to before me by t' O ( L) . On this j Lo--t-L„ day of US OLSLAIC— Ay( .a'Ar + FM1DV s "ioYER Notary Public in and for tiSeState of Iowa Commission Number 729428 My Commi siq) Expires 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). //� Si natureof�Chief or designee Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. Signature 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 derkf axidnvbadgeapp2o1 o.doc 03/2013 lova Department of Transportation eOffice of Driver Services (Toll Free)800-532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX:515-239-1831 Certified Abstract of Driving Record Inquiry Date: 1/16/2014 DL/ID#: 713YY6453 (IA) Customer#: 681803 Name: Martin, Lanny Edward Class: D ID Status: None Address: 5081 AMERICAN LEGION RD Audit#: 4950812 DL Status: VAL SE Issue Date: 01/14/2011 CDL Status: None City/State: IOWA CITY,IA 522409071 Expiration Date: 04/26/2016 CDL Cert Status: None Endorsements: 3L CDL Med Status: None Mailing Address: 5081 AMERICAN LEGION RD Restrictions: Corrective Lenses Restriction None SEDate of Birth: 4/26/1968 Supplement: Mailing City/State: IOWA CITY,IA 522409071 Sex: M History Information Convictions Citation Date _ Conviction Date _ ACD Explanation County JUR 08/04/2011 __. 08/31/2011 mm ��F04 Seat Belt Violation Johnson IA 08/31/2011 10/05/2011 F04 Seat Belt Violation Johnson IA 09/07/2011 _ _ *10/05/2011 _ _ ,_F04 Seat: Belt Violation _ Johnson IA 01/29/2012 04/19/2012 .592 :Speed Cedar IA 03/12/2012 _ _ 07/03/2012 _ __ M14 Fail to Obey Traffic Sign/Signal Johnson IA 06/07/2012 ea 10/10/2012 F04 St Belt Violation Johnson IA 06/11/2012 08/22/2012 F04 Seat Belt Violation _ Johnson IA _ 06/20/2012 09/27/2012 ____ _ F04 Seat Belt Violation Johnson IA - 08/01/2013 08/28/2013 S92 Speed Johnson IA Accidents -Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number _ JUR 05/11/2012 685690 IA Name: Martin, Lanny Edward DL/ID: 713YY6453 Pursuant to Iowa Code §321.10,I, Klm 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: i./ee '- O - ie ..% 1/16/2014 04/ IOWA .a4s : ;Q7 �. 44;::D. O. T.. Catena ,I�hi FOBS%S Office of Driver Services DO • �'kOF P State of Iowa \s F.,o1a, ., /$ ' y,..fs Division of Criminal Investigation 4 4. .1. Z /SQ�� ,A 215E 7`"St ';i ..k.,, c 1 (�I`j IOWA -J�1`is Des Moines IA 50319 �o� NN,"'loin" o /Lr d�y Ph.515-725-6066 Fax 515-725-6080 F'k o '" R" `.�fi�, , P Iowa Criminal History Record Check °A'MIN T/ON p� 1 Walk-In Request Your name 1- a li,I Q Mon/-i-i •-\ Address 5-0 8 I A frpr,fr;rc,n Le foil kci City/State/Zip =zu W ca(' 7- y 7 o Wc� 5)) yr, Fill in all shaded areas. Phone# 319 631 cm/ Requesting an Iowa criminal history record check on: Last Name Ape/!/do(mandatory) }First Name Primer Nombre(mandatory) Middle Name Segundo Nombre(recommended) 71/1 Cl rt r/� /--Gl n /'f� c i'l/g ✓c' Date of Birth Fecha Nacimiento(mandatory) Gender Genero(mandatory) Social Security Number (recommended) (_l /2 '/T+j`/ *ale El Female Li e p2 78 1579 Waiver Signature Firma(If the request is on yourself,please sign. If the request is on someone else,write N/A.) Results' \ DCI USE ONLY As of 1'`'-1 VA , a name and date of birth check revealed: ❑No record found .....j2Record attached, DCI# '31k7_95 DCI initials yiI J Receipt Number of requests ,-,max $15.00 per last name=Total amount$ Method ofpayment:,D ash ❑money order ❑check# ❑MasterCard or Visa Cardholder's name Last 4 digits of MC or Visa DCI initials VA-2) Credit Card Number# Exp. Date IOWA CRIMINAL HISTORY DCI 00374255 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED- 2014/01/14 DCI:00374255 NAME: MARTIN,LANNY EDWARD DOB SEX RAC HGT WGT EYE HAIR SKN POB 19680426 M W 508 275 BRO BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT L ARM TAT R SHLD TAT UL ARM TAT UR ARM CCH RECORD *** 01 ARRESTED 19880415 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION TRK#: L34035901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321A-32 DRIVE UNDER SUSPENSION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L34035901 SENTENCE DISP EFF DAT FINE $150 19880722 02 ARRESTED 19880903 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA204-401-3 POSSESSION SCHEDULE I-MARIJUANA TRK#: L34036101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204-404-4. POSSESSION SCHEDULE I MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L34036101 SENTENCE DISP EFF DAT FINE $150 19890210 03 ARRESTED 19880903 A AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-7 OPERATE MOTOR VEH WITHOUT OWNERS CONSENT TRK#: L34036001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-7 OPER MOTOR VEH WITHOUT OWNER CONSENT DCI 00374255 PAGE 2 OF 3 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L34036O01 SENTENCE DISP EFF DAT FINE $500 19890213 COURT COSTS $60 19890213 04 ARRESTED 20001107 AGENCY: IA0650000 MILLS CO SO CHARGE NO- 02 IA STATUTE IA124-401-5 POSSESSION CONTROLLED SUBSTANCE/ MARIJUANA TRK#: 048872602 COURT DISPOSITION AGENCY: IA065015J MILLS CO DIST COURT COUNT NO- 02 IA STATUTE IA124-401-5 POSSESSION CONTROLLED SUBSTANCE/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 048872602 LICENSE REVOKED SENTENCE DISP EFF DAT FINE $250 20010221 05 ARRESTED 20010110 AGENCY: IA0780000 POTT CO SO CHARGE NO- 01 IA STATUTE IA124-401 POSSESSION CONTROLLED SUBSTANCE W/INTENT TRK#: 800697501 COURT DISPOSITION AGENCY: IA078015J POTT CO DIST COURT COUNT NO- 01 IA STATUTE IA124-401(5) POSSESSION CONTROLLED SUBSTANCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 800697501 SENTENCE DISP EFF DAT JAIL 2D 20010625 06 ARRESTED 20080109 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401 (1) (d) -F CONTROLLED SUBSTANCE VIOL. TRK#: 1A0036F01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.401(1) (D) -F CONTROLLED SUBSTANCE VIOL. COURT CASE ID: 06521 FECR081963 CHARGE CLASS: NON CONVICTION DCI 00374255 PAGE 3 OF 3 TRK#: 1A0036F01 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20080711 FINE $350 20080711 PROBATION 3Y 20080711 DISCHARGED FROM 20100224 DEFERRED JUDGEMENT 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 n