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Home My WebLink About14-004 Authorization Number i 4.- r 1 (Office Use Only) ger® �� 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 Middle Last t Name 2. Mailing Address '>'3 • C`� s�� (k �o�-�� \- \ A-1 } q S \7 3. Telephone: Home (.3\c\1 _55e'> Other: ` J 4. Prior experience in transportation of passengers: --A—c.,c_‘ 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? `4�,p 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? 1-4;;� 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? \D 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) clerWtaxidrivbadg 03/2013 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 5`A > >s-- 'S\\ . 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 Appli•. -` - ` � Date \/\CD/ 1'- ._..,.. ..",,.:tk**..****««*,,*:t* ,.*.. .***.,.,....,.......*... ...... .*........***....*.........*.*........,.,.**..........k***.. .* **.*.*,..*****....***max STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by `3 " ( vi,„„) , , r rt o )--e�j . On this 2C) ('L-day of stat"r WENDY S.MAYER Nota Public in .f d for the State .1 owa 0 rnmmiccion Numhar 72442A • My Com sion Expires taW 4 —r—�' _1 L e ********************************************************************************************.*************************************************** 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). olJ Signature glice r• '-f 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. 746p--t-i---t-A-t----/ 7t )(-/,--,4,(__,L-- r— /0 --1 1 Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 51/2" (height)and prominently displayed to all passengers. ...................................****..*.*.*..*.**..****.*********..******...**.....**.*.................*.....*...*....*.....***...........*. Office Use Only Approved application DCI report State certified driving record Website update cleri taxidrivbadgeapp2010.doc 03/2013 IAIowa Department of Transportation Office of Other Services (Toll Free)800-532.1121 PO Box 5204,Des Moines,LA 50306-0204 515-244-9124 '1111117FAX:515-239.1837 Certified Abstract of Driving Record Inquiry Date: 1/10/2014 DL/ID#: 554XX0811 (IA) Customer#: 604334 Name: Carter,Jermel Class: C ID Status: None Donyea Address: 265 S CHESTNUT Audit it: 7448101 DL Status: VAL ST Issue Date: 10/18/2013 CDL Status: None City/State: NORTH LIBERTY,IA Expiration Date: 11/08/2018 CDL Cert Status: Excepted Intrastate 523179308 Endorsements: L CDL Med Status: None Mailing Address: 265 5 CHESTNUT Restrictions: NONE Restriction None ST Supplement: Date of Birth: 11/8/1975 Mailing NORTH LIBERTY,IA Sex: M City/State: 523179308 History Information CLEAR DRIVING RECORD Name: Carter,Jermel Donyea DL/ID: 554XX0811 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: o�V481Cff$L)i 1/10/2014 mip 14: IOWA *S� r alegge:t4 frlak D. O. T hi, t1, d ilYETr s Office of Driver Services "" Iowa Department of Transporation Name: Carter,Jermel Donyea DL/ID: 554XX0811 Jan. 2.I. 20143 4: 25PMM Div ofvCriminal Investigation No. 9755, P. 1/3 STATE OF IOWA a�' ��1 C4eat ; 7::1 c: 0V1A��; Criminal History Record Check } ?� :.: sr Request Bonn moi,,, , D CI Account Number: moa -.F (Inapplicable) To: Iowa Dlvloloa of Criminal Investigation From: City of Iown City Support Operations Bureau,l'tFloor City Clerk's Office 215 E.1th Street 410 E.Washington Street Dos Moines,Iowa 50319 (515)/25-6066 Town City, TA 52240 (515)725.6080 Fax • Phone: 319-356-5041 Fax: 319-356-5499 • I ant requesting an Iowa Criminal History Record Check on: Last Name (mandatory) First Name(mandomry) Middle Name(reconunandod) CO•, fst r �h- Crr . ocl Cs Date of]Birth owner?) Gender(mandarmy) Social Secure Number (recommended) " /off f VIAto 216a1e OFemale L5 l\ Zb '-vi, X16 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 permbsloa bathe above rcgnrsirng official to conduct an Iowp criminal ldnotyrecord cheek with the Division of Criminal investigation(DCO. Any criminal history dateconcerning me that Is maintained by the DCI may ha Mena as allowed by law. Waiver S:nature: - /72frSu,2ar�,�21`v� Iowa7Cri inn. t:: orvRecord Check Results (DClrrseonly) As of \ \ L\ \LI , a search of the provided name and date of birth revealed: . ' '" 0 No Iowa Criminal History Record found with DCI V Iowa Criminal History Record attached,DCI# " -1" I`i I1 DCI initials fAbi . Receive(Tim?Uec 27 )2013 11 : 19AM No. 9287 . Jan. 2. 2014 4: 25PM Div of Criminal Investigation No. 9755 P. 2/3 IOWA CRIMINAL HISTORY DCI 00549419 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2014/01/02 DCI:00549419 NAME: CARTER,JERMEL DONYEA DOB SEX RAC HGT WGT EYE HAIR SKN POB 19751108 M B 506 150 BRO ELK MER IN ADDITIONAL IDENTIFIERS TAT R ARM CCH RECORD *** 01 ARRESTED 19970414 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401-5 POSSESS SCHEDULE I/ MARIJUANA TRK#: 032247601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 POSSESS SCHEDULE I/MARIJUANA CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032247601 SENTENCE DISP EFF DAT FINE $300 19970014 • 02 ARRESTED 19981226 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA708-2A(22) DOMESTIC ASSAULT CAUSING BODILY INJURY TRK#: 032258501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA236-2 DOMESTIC ABUSE/ASSAULT/CAUSE INJURY CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032258501 RESTITUTION SENTENCE DISP EPF DAT JAIL 60D 19990423 PINE $250 19990423 COURT COSTS 19990423 PROBATION lY 19990423 03 ARRESTED 20010415 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA708-2 ASSAULT/INJURY/DOMESTIC TRK#: 100215201 COURT DISPOSITION • AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA723.4 ran. 2. 2014 4: 25PM Div of Criminal Investigation No, 9755 P. 3/3 DCI 00549419 PAGE 2 OF 2 DISORDERLY CONDUCT COURT CASE ID: 06521 AGCR058550 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100215201 SENTENCE DISP EFF DAT JAIL 4D 20010924 CREDIT W/TIME SERVED 20010824 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 TRE 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 INVESTIGATIO//,N�'In'�J