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Home My WebLink About18-063IDENTIFICATION NO.. �l r l (Office Use Only) APPLICATION FOR TAXICAB / 11"D REDICAB VEHICLE DRIVER — (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday) CITY OF IOWA CITY 20183111 _a ow ,. 410 East Washington Street rallure rO Complete the "required" /nformBt/d/f lvl/frL•'s/dt /n denial Of the application Iowa City, Iowa 52240-1826 CITY CLERK (319) 356-SO40 IOWA CITY. IOWA (319) 356-5497 FAX First Middle Last ,r 1. Name (REQUIRED) tZNr �L A 1 Fe -1.20, 2. Address (REQUIRED) P r, 3. Contact Information (REQUIRED) Email l L, J.(6 -cell Phone: 25�/ All written communication sent Va email) 4a. Driver's License expiration date (REQUIRED) 2 — I'T — Z, Z u b. Taxicab Business Name (REQUIRED) \1 v I (to—, cc, h O-� taw ti C1 _ 5. Prior experience in transportation of passengers: r, 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type ofoffense Where When I�JJ i�r e Di. rp1� j /i/ 21 fCC4 What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where When . ft 91) y ( 1�>S t.t r (- y �,c 0 What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense Where . I When fy J Yui — 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STAIg CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLIC I jItF ` u You must apply for an individual Department of Criminal Investigation Report (form available upon request). 1018 JUL -9 PM 2: 55 CITY CLERK I hereby certthat I have issued to me by the Iowa Department of TransportatiJPW4.4ATlYA%kiW cense number 0-):) � � o 3 � (4 issued on 5 - 1 b - I 'texpiring on Z- I B -2o . I understand that if falsely answer any questions in this application, that this application may 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 authorization to be a taxicab driver 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 Date--) - Cl - / 0 •+��,r�m�sr��m++t++�+��eetwr�tt�rM+��ewwtia+tir��r�i��,.�t�a+e�eMi�*�+*�+*��e+++wr«« STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by -6 Crc.% (hexA L. H w,on this day of 'Sl , I . - �r a 91 'S� I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). ;ignat xpiration d 4 F r' � GZ X17 r Police Chief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. C _D or Office Use Only Approved application DCI report State certified driving record Website update CI.WTAXIDRN "114PK92018eme .WC -c/- / b Date 04/2018 �410WADOT FILED SMARTER I SIMPLER 1 CUSTOMER DRIVEN WWW-- 5 Dom a ww$Wd aloe atlivleas Po llwc 900a I bits ��g�s Phone 815-264-51 � W A Certified Abstract of Driving Record ��''UUUUV��11111fFFhNNiil rriihl Inquiry Date: 6/27/2018 DL/ID #: 077BB0374(IA) Customer #: 4068470 Name: Hayes, Brandon Class: D ID Status: None Allen Address: 1112 PARKWAY DR Audit #: 2155453 DL Status: VAL Issue Date: 09/16/2017 CDL Status: None City/State: BETTENDORF, IA Expiration Date: 02/18/2020 CDL Cert Status: None 527223042 Endorsements: Chauffeur 2 CDL Med Status: None Mailing Address: 1112 PARKWAY DR Restrictions: NONE Restriction None Supplement: Date of Birth: 02/18/1987 Mailing BETTENDORF, IA Sex: M City/State: 527223042 History Information Convictions Citation Date Conviction Date ACD Explanation County7UR Explanation L01/0412015 101/28/20 5 864 No Insurance Card Scott IA Sanctions Type Effective End ACD Explanation Occurrence 7UR 7UR Suspended 09/28/2015 12/07/2015 D53 Non -Payment of to IA Iowa Fine Name: Hayes, Brandon Allen DL/ID: 077BB0374 Pursuant to Iowa Code §321.10, I, Darcy Doty, Director of Driver & Identification Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by Driver & Identification 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: Name: Hayes, Brandon Allen DL/ID: 077BB0374 6/27/2018 Driver & Identifiwu*4 PM 2,55 Iowa Department of Transporation CITY CLERK IOWA CITY. IOWA Jul. 3. 2018, 4:37PM Div of Criminal Investigation Ootcilcula iCautruuwCob I No. 5762 P. A2 ry (FAX)318338Zrua r.4021002 To: Iowa Division orCrlminal lovesilgation Support Operations Bureau, I" Floor 215 E, 7" Street Des Moines, Iowa 50319 (515)725-6066 t (515) 726-4080 Fax I em requestintt an Iowa Criminal'Hisrorv'r�tecord Check on: DCT Account Number: 9967-F (ifapplies6le) Front) Yellow Cab of Iowa City P.O. Box 428 Tra City, IA. 52244 (319) 338-9777 Phone: Fax: (319)339-7302 Last Name (munluory) v� STATE OF IOWA I`` l AYES Cir'6iaal History Record Clieck . v n Request Form g , i v To: Iowa Division orCrlminal lovesilgation Support Operations Bureau, I" Floor 215 E, 7" Street Des Moines, Iowa 50319 (515)725-6066 t (515) 726-4080 Fax I em requestintt an Iowa Criminal'Hisrorv'r�tecord Check on: DCT Account Number: 9967-F (ifapplies6le) Front) Yellow Cab of Iowa City P.O. Box 428 Tra City, IA. 52244 (319) 338-9777 Phone: Fax: (319)339-7302 Last Name (munluory) IPiret Name (m.ndaw Middle Name (r000mmcnded I`` l AYES iSr _a. f3Rflr r1�4iJ� I -tet„ Ate✓ Date of Birth (mandatory):.Gender (maodaro ;SoclaLSecurl Number (reeommendcd) IGX -7' [maj;ll le ❑Female SM ' Li �.—�l2_6-gLIZ Waiver Information: Without a Signed Waiver from the subject of the rcgvest, a complete criminal history record tray not be releasable, per Code of lows, Chapter 6 2.2, For complete criminal hiatory•recor in(ormQtion, aq allowed by haw, always obtain a waiver sl nature from the sub ectbf the Le quest Waiver Release: I hembygivc permission for (he'ebovc requating o,aeia) to conduct an laws criminal h=tyraw d cbeck with tho Division of Criminal Investi[arlon (DCI). Any criminal history daa concerning me that is maintained by the D61 may be released as;allowcd bylaw. Waiver Signature:_ (DCI use only) As of 7! 3 i g a search of the provided name and date of birth revealed: No Iowa Criminal History Record found with DCI } ClIeEl Iowa Criminal History Record attached,•DCI # 1 Tl i" DCT i(iitiais Ca DCT -77 (08/25/16) Received Time Jun. 27, 2018 2:20PM No, 1273 Jul. 3. 2018 4:37PM Div of Criminal Investigation No. 5762 P. 2/2 DISCLAIMER This response can only include public criminal history data. Under Iowa law, most juvenile records are confidential, Confidential Juvenile court records, if any, cannot be Included In this response. A signed release authorization Is riot sufficient to obtain this information from the Division of Criminal Investigation. In order to request the release of confidentialluvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: htipJ/www.iowasexoffender.com/, However, even though some information is available on this site, the actual records forjuveniles may still be confidential and any confidential juvenile records cannot be provided with this record. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18). N O_ � W C-) c, ;<rrn s js'I')j D CA Cn