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Home My WebLink About14-003 Authorization Number /Li— 3 i (Office Use Only) Ecar 0461,. 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.) to a City. Iowa 52240-1826 i119) 356-50407 (319) 356-5497 FAX First �1 lddle II '',, Last 1. Name 1 L�0.� J O\e� W; �) „- 2. Mailing Address o� of�c ) Q s- 3. Telephone: Home 3 )9- 7 ? Other: . 4. Prior experience in transportation of passengers: I �I./L.._ c. �2�Qrw c. q}- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 40 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? \! Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 2i,.,� y ,; 1 ate,fiJt- , 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 'vo 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) derkttaxidrivbadg 03/2013 I herebyq certifti,t .a I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 1 Vit- \----))`I 50 . 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 I i �`. /A U Date I I \\`i V1. STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by f1 l i L,,Q. j L,1 l;ay..._ 8- j . On this {__ day of �.tANAa (-4 ,zOH . r1 .• WENDY S.MAYER •• , ,,,:r 729428 Notary Public inf nd for the State ,'' Iowa '• i.l '' My commission Jssion pees ow ************************************************************************************************************************************************ 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). Signature Police F. -for 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. 9'e'4_ r-y�,d---) ICI , --17_,f,„4,--) 1 CE2:,4 LI Sfgnatire 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 clerkftaxiddvbadgeapp2010 doc 03/2013 Iowa, Department of Transportation .;.. Office of DriveServices �Tdi Free)860 532-1121 PO Box 9204,Des Moines,IA 50306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/3/2014 DL/ID it: 091FF3450 (IA) Customer#: 4069858 Name: Williams, Michael Joseph Class: D ID Status: EXP Address: 2225 10TH ST Audit#: 6600804 DL Status: VAL Issue Date: 01/09/2013 CDL Status: None City/State: CORALVILLE, IA 522411327 Expiration Date: 12/18/2014 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 2225 10TH ST Restrictions: NONE Restriction None Date of Birth: 12/18/1965 Supplement: Mailing City/State: CORALVILLE, IA 522411327 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County JUR 10/23/2001 10/21/2002 A20 Operating While Intoxicated .Johnson IA 05/05/2010 06/21/2010 S92 Speed (10 mph &under In 35-55 mph zone) Johnson IA 03/20/2013 05/05/2013 592 Speed (10 mph &under In 35-55 mph zone) Johnson IA 04/13/2013 05/15/2013 S92 Speed Johnson IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked 10/21/2002 10/20/2008 A20 Operating While Intoxicated IA IA Name: Williams, Michael Joseph DL/ID: 091FF3450 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: te. .ss 1/3/2014 Mt IOWA '43' a W;� ). O. T. :W �,,'4�Of hugs Office of Driver Services Iowa Department of Transportation Name: Williams, Michael Joseph DL/ID: 091FF3450 Dec. 31. 2013 10: 51AM Div of Criminal Invest igation No. 9522 P. 1 ve.. Li. LVID 7, 471111 VI s Vfefll — Vl cy UI IUWd VI Ly No. 9C(ti P. i STATE OF IOWA citify 'ilir t ce_ ord IA::; Criminal History RecCheck pp. s � ' , citify :• ••-9. ,;,-,:'.. •---410,1,A DCI AccountNumber: 4-oo a.- F (if applicable) To; Iowa Division of Criminal Investigation Vona; City of Iowa City Support Operations Bureau,I'afloor City Clerk's Office • 215 E.791 Sheet 410 E.Washington Street Des Moines,Iowa 50319 (515)725-6066 Iowa City, IA 52240 (515)725-6080 Fax • Pisa: 319-356-6041 11116 • Fax: 319-366-5497 I=requesting an Iowa Criminal History Record Check on: Last Name (mandatory) First`Name(mandatory) Middle Name(reconm,ended) • W 1 \\t e.rr ` nr I C1-\N 1.a<\ u'$eQ 2 ' Date of Birth(mandatory) Gender(mandatory) Social Security Number(recommended)1 \ 1NQIWiCC �IV1ale CiFemale 3 L1-- 6a.-3330 Waiverinforma/1on:Withouta signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code of rowa,Chapter 692.2.For complete criminal history record information,as allowed by law,always obtain a waiver signature from the subject of the request. J DTaiverRelease:Iherebygivepermissiontor1heakov+requunngofcialtoconductanloevaciim)nalhisioryrecordcheekcrhhtheDtvislonofCriminal ' InvesligaIion(DCI). Any etlminal history data coneemhsg me that Is maintained by lh DC may be released as allowed by law, Waiver Signature: �', I • I_ I . �9 4 Iowa Criminal History Record Check Results • (DC14011ly) `: 11 • • , e : ..1 As of 1 1'.�1` 1/4 '� , a search of the provided name and date of birth revealed: ') � • I i 1 ® No Iowa Criminal History Record found with DCI cp ' .f) rIowa Criminal History Record attached,DCI# 3 G(9 63NA Del initials kSt-____ R e c e i v e rfimne76ec.I'3./)2013 4:28PM No. 9157 Dec. 31. 2013 10: 51AM Div of Criminal Investigation No. 9522 P. 2 IOWA CRIMINAL HISTORY DCI 00366634 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OP 3 DATE PRINTED- 2013/12/31 DCI:00366634 NAME: WILLIANS,MICHAEL JOSEPH DOB SEX RAC HOT WGT EYE HAIR SKN POD 19651218 M S 602 170 BRO BLK BLK IL ADDITIONAL IDENTIFIERS SC AEDOM SC L KNEE CCH RECORD *** 01 ARRESTED 19070920 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA708-2 ASSAULT • TRK#: L32981901 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA708-2 ASSAULT CHARGE CLASS: MISDEMEANOR CONVICTION TRK$: L32981901 SENTENCE DISP EFF DAT PLEAD GUILTY 19870920 FINE $75 19870920 COURT COSTS $20 19870920 02 ARRESTED 19890514 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321-210-A DRIVING UNDER SUSPEND TRK#: L32982001 CHARGE NO- 02 IA STATUTE IA321-210 DRIVING UNDER SUSPEND TRK#: L32982002 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321-210-A DRIVE UNDER SUSPEND CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L32982001 SENTENCE DISP EFF DAT PLEAD GUILTY 19890515 FINE $25 19890515 COURT COSTS $10 19890515 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE IA321-210 DRIVE UNDER SUSPEND CHARGE CLASS: MISDEMEANOR CONVICTION Dec. 31. 2013 10: 51AM Div of Criminal Investigation No. 9522 P. 3 DCI 00366634 PAGE 2 OF 3 TRK#: L32982002 SENTENCE DISP EFF DAT PLEAD GUILTY 19890515 FINE $25 19090515 COURT COSTS $10 19890515 03 ARRESTED 19900113 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA236-12 ASSAULT CAUSING INJURY-DOMESTIC ABUSE • TRK#: L32982101 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA723-4 DISORDERLY CONDUCT CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L32982101 • SENTENCE DISP EFF DAT JAIL 5H 19900427 FINE $20 19900427 CREDIT W/TIME SERVED 5H 19900427 04 ARRESTED 19941211 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 012456201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 012456201 SENTENCE DISP EPF DAT JAIL 48H 19950223 FINE $500 19950223 00 ARRESTED 19961024 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: 027165301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(H) OPER VEH WH INT (OWI) / 2ND OFFENSE De'c. 31. 2013 10: 51AM Div of Criminal Investigation No. 9522 P. 4 DCI 00366634 PAGE 3 OF 3 CHARGE CLASS: MISDEMEANOR CONVICTION TRK4: 027165301 SENTENCE DISP EFP DAT SUSPENDED JAIL 53D 19970207 JAIL 60D 19970207 FINE $750 19970207 PROBATION • 19970207 06 ARRESTED 20011023 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 3RD OBFENDE TRIO: 100376201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(B) OPER VEH WH INT (OWI) / 2ND OFFENSE COURT CASE ID: 06521 OWCR060267 CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 100376201 SENTENCE DISP EFF DAT JAIL 140 20021021 FINE $1500 20021021 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD • MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICAT N IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON-LAW ENFORCEME CIES BY THE DCI. IN THE AB ENCS 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