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Home My WebLink About18-066� r l IDENTIFICATION NO. — (Office Use On y) ._ APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made between 8 a.m. to 3 p.m., Monday– Friday) 410 East Washington street Failure to complete the "required" information will result in denial of the application Iowa City, Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX Last t-� 1. Name (REQUIRED) 1 1d� ,� 2. Address (REQUIRED) 3. Contact Information (REQUIRED) Email: SI( (All First Middle _-- k_ –�Gwo' "V(-- 11A9 JAS VC CVW I i" Cell Phone: NQ SI!i' 33� vritte'n (communication sent via email) 4a. Driver's License expiration date (REQUIR\E1D) U4 I 0 a I 0\U Ci` 3 b. Taxicab Business Name (REQUIRED) yQ I\wW cct-) ) 5. Prior experience in transportation of passengers: 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? KID Typeof offense Where When ..a o �n �r a rn rn — ::1z = 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? 1 Ao Type of offense Where When 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? t A0 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) SIGNATURE AND 04/2018 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 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). r(e�by certify that I hTe issued to me by the Iowa Department of Transportation a valid Driver's license number C , 4\L. ;� c:�K iseuxl on I • �r 2ol—I rrnirinn on r LI.h,4 • ,a(1ad I H.-+ 9 1 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 visions of Tit a 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of App li Date 7 (3 . 1 STATE OF IOWA ) COUNTY OF JOHNSON ) N Subscr' and sworn to before me by 514 l4 `f I � 4A 'r, yon t Ou�mythis � day of CD tllEtlDY S. 11111111011 Notary Public ifdand for the State of _ t— �r rn oVIC = -- I have reviewed this application, DCI report, and the State certified driving record of this applicant have -determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or are of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration date of D W s license Oy-07,-Z3 `�17 07 -/J -/g Sig ure of 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. Signalk.ire of City Clerk orde g�si nee Office Use Only Approved application DCI report State certified driving record Website update Date OeNrA%lDRRA nA EAPP,M18aImdad ooc 04/2018 07113/2018 10:59 Yelow Cab (FAX)3193382708 P.0011001 4P10WAD.0T* (0114Tth ! UMO t:11 a rMTnUrn firlmr f V!!'iryM1d-20wadotgo ;1 FFtArDr 8 VSSei�tifitaSaD &Yttiieies Pa6wt� Deis litrtileg, iA 9tl9F16.�04 P11w W 3115244.9124}Faic Sia -ass -1W Inquiry Date: 7/5/2018 Customer ad: 631A1R0 Name: McCraig Thomas, Shanika rm�a, Tieara Address: 1232 ESTHER CT City/State: IOWA CITY, IA 522402561 Mailing 1232 ESTHER CT Address: Mailing IOWA CITY U52M2561 City/State: Date of Birth: 4/2/1990 Sex: F Certified. Abstract of-Drlvirtg Record None DL1ID #-. 88&AL3589 (IA) FDL Permit pass None rm�a, r Jnr o.—. Ta... u9.,. CDL Permit Status: ELG Date: Audit if: 15.24777 CDL Permit None Expiration Date: Issue Date:. 01103/2017 CDL Permit None Endorsements: Expiration Date: 04/0212023 Endorsements: NONE: Restrictions: Corrective Lenses Restriction None Supplement: History Information - CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: None CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: None CLEAR DRII7ING RECORD 0 �n G Name: McQalg Thomas, Shanika Tleara DL/IDp:886AL3589 (tA) r � r W 1 Pursuant to Iowa code 9321.10, I, Darcy Doty, Driver a Identification Services, Iowa Department ofTrsmportanon, �'YeAebv Fy tfn the Custodian of the records held by Driver 9 Identifcation Services, that this i5 a true and. accurate copy of an official re merrtly in th�ee�totly- e said office, and that have been authorized by the Director of the Iowa Department of Transportation to so certify. Y„� r. S� In witness whereoF, I have caused my signature and the seal of the Department m:beset upon this tlocumenk,:abAnkeny, Iava th3iate: Name: McCralg Thomas, Shanika Tleara DLLIDL 886AL8589 (III) �1?x+19 Driver Ai0strulicadon Services Iowa Department of Transportation I ,.Jul.11. 20181, 9:14AM�cabDiv of Criminal Investigation t (FAM19338N;U6265 P. 1v� Ur2iOO2 Y STATE OF IOWA Cr'jminal History Record Check ' Request Porm 4b: Iowa Division of criminal InvaAgetioo Support Operations Bureau, I'r,•jlloop 215 L. 7" Street ' . Des Moines, lows 50319 (515) 725-6066 (515) 7254080 Fax -T. e DCI A000uBr Number; 9967-F (if applicable) From: 'Yellow Cab ofloy&CltV _ P.O. Boz 4z8 m _ (319) 338-9�T" phone: 1 S�4 Fax: (3X9) 339 73 _ Male �emale CM V � Waiver liljormatlonr Without a slgned Waiver from the subject of the request, a r ompleta 4rbninal history. record q,qy not be releassbhe per Code of Iowa, Chapter 692.2. For c t criminal historyrecor obtain a waiver signatureil Igfortnstion, at{ allowed by ►aw, attvays from the subidct::nf the reno.cr Waver Ra Ida e:I homby givc pttml,$,Qn for the'eheve squatting Official to Conduct an Iowa criminal Invbbtery record chCck with the Dlvialm ofC,imind Ctdgition MCU MY rrimsnol history data c oemin`mo that is maintained by tpa Dci tea bt chased a71 itow . 7 c6 bylaw. WaiverSirnafurall� I ✓� X V L1 /% Iowa Crimiinal istory Record Check Results CM uss only) As of a Seare'(i of the provided name and date of bjttb rervealedi V No Iowa Criminal Kato,Fy Record found with DCI j+ �U c, r ? f?Cl }. Iowa Criminal History k6cord attached, DCI # ' c ACI -77 (08/25/10) Received Time Jul, 5. 2018 11:33AM No. 5806 Jul -11. 2018 9:14AM DISCLAIMER Div of Criminal Investigation No -6265 P. 2/2 This response can only Include public criminal history data. Under Iowa law, most Juvenile records are confidential. Confidentlal Juvenile court records, if any, cannot be Information from the Division of Criminal Investigation. In order to request the included In this response. A signed release authorization is not sufficient to obtain this confidential juvenile records, If any, an application must be filed pursuant to Iowa release of 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: ht!p,'Ilwww.lowasexoffonder.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). H 0 O DC-) eo C r �rn a rn