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Home My WebLink About18-101� r l lk- 4014 CITY F IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319)356-5040 (3 19) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED 3. Contact Information (Fccuumnij) tmair IDENTIFICATION NO. (Office Use nly) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday) Failure to complete the "required" information will result in denial of the application written communication sent via email) 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: Cell Phone: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Tvce of offense When Jwl zmm What happened to the charge? (Circle one) N Uv -y 7 _� onvict Dismissed Deferred SuspendedPlead Gui r-Othw M 7. Have you been arrested / charged with any traffic offenses in the last five years? S Type of offense Where Why? Ce- What happened to the charge? (Circle one) (5o:n:viict> Dismissed Deferred Suspended Plead Guilty Other 8. Has your drivers license or chauffeur's license been suspended or revoked in the la five years? 110 Tvnp of nffpnep Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the rtame(s) (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 �Yf ly A l ✓� �, m 1u, II 1999 j. 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). I hereby certify that I have issued to me by the Iowa De agMent of TrfrSs �+atao a valid Driver's license number issued on ��'� expiring c _. I understand that if falsely saver any questions in this application, that this appuceticafinay be denied. . ujree-tnac 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 th (Needs to be signed in frontq a Notary Public) Signature of Applicant /jy�.•!/Q/— Date__ ® _ n C-) cn –•1 c7 STATE OF IOWANi COUNTY OF JOHNSON ) ro J Subscribed and sworn to before me by �_T l ,¢ 60V -ti (2' on this 5 day of y0 r NDY s, MAYER _ f) for the State of 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). Expiration date of iv license Si re 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. Clerk Approved application DCI report State certified driving record Website update 0&*fr"DR1Va4DGEAPPL92018an*nd tl.DOG Office Use Only f –R Date 04/2018 410WADOTA0 SMARTER I SIMPLER I CUSTOMER DRIVEN WWW'IOWBCIOt gOV odd & IdMRilication ssrWas PO eat 92D4 I On Mtl W IA ISOW&-92U Piqua: &15,24441241 FSK 513339.1837 Inquiry Date: 10/5/2018 Customer #: 1934738 Name: Toomer, David Alan Address: 2742 500TH ST SW City/State: KALONA, IA 522479214 Mailing 2742 500TH ST SW Address: None Mailing KALONA, IA 522479214 City/State: None Date of Birth: 9/21/1956 Sex: M Convictions Certified Abstract of Driving Record DL/ID #: 127AC6033 (IA) Class: D Audit #: 9285470 Issue Date: 07/28/2015 Expiration Date: 09/21/2023 Endorsements: Chauffeur 3 Restrictions: Corrective Lenses Restriction None Supplement: � History Information CDL Permit Class: None CDL Permit Issue Date: None CDL Permit Expiration None Date: � CDL Permit None Endorsements: IJt e CDL Permit None Restrictions: pppO� ID Status: EXP DL Status: VAL CDL Status: None CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: t� None '!IA C 0 � 1863060 1� C -4, IJt e Citation Date Conviction Date ACD Explanation 1"1 Yi1R aCounty 11/17/2013 12/09/2013 N82 jImproper Backing -C--- ��;o f16 Johnson N Accidents -Accident involvement indicated does NOT mean the individual was at fault or given a citation. —1 Accident Date JUR Case Number 11/17/2013 '!IA 767955 06/10/2015 - IA -- 1863060 01/29/2016 IA 1904490 Name: Toomer, David Alan DL/ID: 127AC6033 (IA) Pursuant to Iowa Code 4321.10, 1, Darcy Doty, Driver & Identification Services, Iowa Department of Transportation, do hereby certify that I am the custodian of tht 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 bee, authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, 1 have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: S�ENI Oi SAS S "oy 10/5/2018 cent Driver & Identification Services pppO� Iowa Department of Transportation Name: Toomer, David Alan DL/ID: 127AC6033 (IA) Uct. 4.ZUId 9:Z/AM Div of Criminal Investigation 10/02/2010 1203PII FAX 3103707302 STATE OF IOWARCriminal History Record Check 9 Request Form To: Iowa Division of Criminal Investigation Support Operations Eureao, I" Floor 215 S. 71° Street Des Moines, Iowa 50319 (515)775-6066 (SIS) 7286080 Fax Ism No. 6759 P. 1/5 10 0002/0002 DCI Account Number: _9967_P (Itlppllaeblc) From: _Yellow Cab Of,Iowa City P.O. $ox 42$ Iowa Clty, IA, 52244 Phone: (319) 338-9777 Fax. (319) 339-7302 / -� ) ' lyjrr, EdMaie [Female- _�j Waiver infprmatton: Without a signed waiver frau the subject of the request, a complete criminal hint/ record zitay not be releasable, per Code of Iowa, Chapter 692.2. For complete eriminal history -record Information, as a110Vt3d by law, a)wsys obtain a waiver ri nature from the subject -of the request. m Waiver RCLCaSes I hereby glue permiss oa for the above requesti119 01111CIRI 19 Wriducil art laws ]aoryrar s(OCT).y so y duo oncoming mo that IS mointafn �me i sion a❑ ad a ellOwoa by Isw�(l inol Waiver Signature; —rt/ Iowa Criminal History Record Check Results AS of l O • Ll . I a search of the provided nnmc and date of birth ❑ No Iowa Criminal History Record fowid with DCI Iowa Cyiminall-Iistory Record attached, DCI 0 2 o ( 5 � DCI inidale DCI -77 (08/25/10) Received Time Oct. 2. 2018 1:05PM ND -6447 C;t QRPl one only) :ice• ... i t.r) S i' 1.LV10 r:trnni Uiv of Criminal Investigation No. 6759 P. 2/5 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00209152 NAME: TOOKER, DAVID ALAN DOB SEK RAC HGT WGT 19560921 M W 511 200 ADDITIONAL IDENTIFIERS Sc CHIN SC R KNEE DCI 00209152 PAGE 1 OF 3 DATE PRINTED - 2018/10/04 EYE HAIR SKU POB BRO BRO MED IA CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19780203 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRK#: L10173201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO p15T COURT COUNT NO- O1 IA STATUTE: OPERATE MOTOR VEHICLE UNDER INFLUENCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173201 SENTENCE JAIL 10D 02 ARREUTED/TAKEN INTO CUSTODY 19660716 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC TNTOX TRK#: L10173401 COURT DISPOSITION AGENCY; IA092015J WASHINGTON CO DIST COURT COUNT NO- O1 IA STATUTE! IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173401 SENTENCE JAIL 2D 03 ARRESTED/TAKEN INTO CUSTODY 199011D3 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- O1 IA STATUTE IA321J-2 owl TRK#: L10173501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2 OPER VES WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRX#• L10173501 SENTENCE DISP EFF DAT 19791120 DISP EFF DAT 19860717 DISP EFF DAT rr�{ Fp-q-9 Q 60E0666T a2 7IYP Iva 333 dSTa 3JN3IN3S 100909900 : #MIL NOIIJIANOO )1ONY'3W3QSIW :SSK'IO 3DIIYHO a8XOA8H rum ONIAIHa TZ-PTZ£YI :3ILIIYIS VI TO -ON INnOO IHf10O ISIa 00 NOSNHOP PSIOZSOYI :AON29V NOISIsodsla unoo 6ZIOC66T 6ETO£661 S'da 933 dSIa VtZOZ66T VTZOZ661 IYa 8d3 dSIa 4TZ0T661 6IZOT66T 6TZOT66T E 40 Z EOYd ZST60Z00 IOU 1009959Oo :#X-dL Q3xOASH S'IINM DNIAIHa TZ-PTZE1[I 91CLIVIS YI TO -ON 3DHYH3 ad 7.IIJ 74OI OOZOZSoKI :A3N80Y 9ZITE661 AOOy9A0 OSNI N7xPly/a8IS87jHY 90 OSL$ 3NI3 3ON3yN39 104ELTOI'I :#)JUL NOIJJIANOO 'dON1C3W3aSIW :SSY'IO 3OHYHO 89N8d10 QNZ/SMO aln"Me YL TO -ON IMOD IHnOD Isla oa NOIDNIHsYM PSTOZ60YI :AONBDY KOLUSodsla IHnOO TOLELTOT'I .#xHI HSN388O aNi/IMO Z-PTZEYI 3JMIKIS YI 10 -ON 20,dv O Os 00 NOIONIHSYM OOo0Z6ovi ;Z)NHDY TOOTC66T Aa0ISaD OyNI NH]IYy/aay68HHY SO HPT Camas 3WIL/M I2agEo a0T 7IYP 3ONaINas T09£LTOI4 :#MHI NOIIOIANOJ HONY3W3a9IW : SSY'IO 30ilYHO yN3aIJOY Auam 4YNOSHBd do mms 88y 3AY87 19Z-TZEYI :3IOIYIS YI TO -ON INAOO INROD ISIa 03 NOSNHOP PSTOZSOYI :AON8'JY NOIAISOdsla yxnoo T09E6TOT7 :#XHI IN9aIDOY 3o HN3Js sAY7R E9Z-TLEYI 3LnLYIS YI TO -ON BDHYHO OS 00 NOSNHOP OOOOZSOYI=A3N3EIY Y EOIT0661 Aa0y8an OSNL N3Kity /QSysgHHY ;0 HVC a3AH3S 3WII/M II03HO OOS$ 3NId az 'I IYI' S/E 'd 6SO '°N U01jP21}San1.11 JeuimiJO Jo Ala WV/ 7.:6 A167'b ion Uct. 4.2018 9:27AM PINE Div of Criminal Investigation DCI 00209152 PAGE 3 OF 3 $250 19940304 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 THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE OT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No. 6759 P. 4/5 Oct. 4.2018 9:27AM Div of Criminal Investigation No -6759 P. 5/5 DISCLAIMER This response can only include public criminal history data. Underlowa law, most Juvenile records are confidential. Confrdentlaijuvenlle court records, if any, cannot be included in this response. A signed release authorization is not sufficient to obtain this Information from the Division of Criminal Investigation. 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). Additionally, criminal history data concerning convictions for cerla/n juvenile sex offenses can be found on the Iowa Sex Offender Registry.• htt ://www.lowasexaffender.com/. However, even though some information Is available on this site, the actual records for juveniles may still be confidential and any confldentlal Juvenile records cannot be provided with'this record. In order to request the release of confidenfial juvenile, records, if any, an application must be filed pursuant to Iowa Code section 232.147(18), N � 4"W • C� i e C-) 1 �� N GO