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Home My WebLink About14-009 Authorization Number I - 4 1 (Office Use Only) III 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 Era, Middle Via, Last \A0a S 1. Name Q -L-0\A)0., 2. Mailing Address f • R(� ?� C� ��w CY s _-z(-1c1 3. Telephone: Home -242--(47(0 I - Other: 4. Prior experience in transportation of passengers: N 1 A 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? �J Type of offense Where When 6. Have you ben convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? A Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? , Type of offense Where When F4I !UrZ 4 Ckk{ Sira 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ?J 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 s I hereby ce ify that_I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number / /4f p Q 2.2-- . 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 a'(,� > L Date ,�'7 2' STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by ---f k C. 3-- o cQ-e Jr . On this 1 7j r'", day of �nvtudM fir)/4. �ra1Ara WENDY 5.MAYER _ al- ._ • A " F ; Commission Number 729428 Notary Public in an.. or the State of I. a My Cunnnlasirrurr EwNu ca 0 ��II(�J *********************************************************************************************,*********k**************************************** 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). /- /V / Signatu e 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. 7/( -1--4=a-l•-t-/ i<-:-/ • il .-41.----) 2- j 5 --)q Signa 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 clerWtaxidrivbadgeapp2010.doc 03/2013 Iowa Department of Transportation Office of Driver Services (Toll Free)800-532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/14/2014 DL/ID#: 461AF0022 (IA) Customer#: 5744618 Name: Rhodes, Eric Jamal Class: D ID Status: VAL Address: 2110 BROADWAY ST Audit#: 7660511 DL Status: VAL APT] Issue Date: 01/02/2014 CDL Status: None City/State: IOWA CITY, IA Expiration 10/04/2016 CDL Cert None 522407035 Date: Status: Endorsements: 3 CDL Med None Status: Mailing Address: PO BOX 1884 Restrictions: NONE Restriction None Date of Birth: 10/4/1987 Supplement: Mailing City/State: IOWA CITY,IA Sex: M 522441884 History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 11/04/2012 01/07/2013 M16 Fail to Obey Traffic Sign/Signal IL 12/11/2012 01/14/2013 Improper Registration Johnson IA Name: Rhodes, Eric Jamal DL/ID:461AF0022 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: 1.W CIF p„ya /p14 1/14/2014 •(3t) Ti ff tMi%$ I IowaOfficDepartment ofDriver of ServicesTransportation Name: Rhodes, Eric Jamal DL/ID:461AF0022 Jin. 8. 20)41 10:.14AMA Div of Criminal Investigation No. 0040 P. 1/8 • � :• • STATE OF IOWA ,.�� Ing, > , Criminal History Record Check (i,..: x " A�' Request Form DCI Account Number: jpo.2.^f (if applicable) To: Iowa Divisloll of Criminal Invesllgatiou From: City of Iowa City Support Operations Bureau,tri B'loor City Clerics Office 215 E.7th Street 410 E.Washington Street Des Moines,Iowa 50319 I , (515)726.6066 Iowa City, IA 52240 (515)725-6080 Fax phone: 319356-5041 Fnx: 319-356-5497 I amrequesting an Iowa Criminal IdistoryRecord Check on: ast Name (nvndatory) First Name(meadotory) Middle Name(reconaceadr4) Rhodos Crui, J/40404 Date of Diirth(mandatory) Gender(mandatory) Social Security Number(recommcndcd) )01—all— 1C187- E‘ale QFemale 35S`72 -09 (Q 1 waiverinforntation:Without a signed waiver from the subject of the request,a complete criminal history record may no( 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 sublect of the request. Wilber Ihcrcby givepermission for the above requcating 011101)1 to conduct an low•4 criminal historyrtcord cheek with sha))Ivhion of Criminal Investigation(DCI). My Criminal history dela conte' i)rgme that is m in. bythe Det may bo rolcsscd as allowed by law. Waiver Signature: - 4 ( , t .J a� , d ! Iowa Criminal history Record Check Results (D s0 ) � IO19 �. 5.1 As of a search of the provided name and date of birth revealed; <' :11—,,.. liarNo Iowa Criminal I-Iistoiy Record found with DCI 9=e v (fi T nit p Iowa Criminal l�istoryltecord attached,ACI# 0 N n • DCI initials I% 2ece ivedime7Jan(Ici.q)2014 4: 18PM No. 5906