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Home My WebLink About18-107r 1 r atlrl®i�� CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED IDENTIFICATION NO. _ (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED ICAB 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 First Middle 3. Contact Information (REQUIRED) Email: GAt.E—Cell Phone:3(� (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) g4 t I (Z I Z -- b. Taxicab Business Name (REQUIRED) ' (;,LL" CA -F3 cF 10A -A CI -M 5. Prior experience in transportation of passengers:6y'� b Y tt5 Ccl nP I wW V rca 6fix', a C)L0 c/t k TD - Cf�S 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? IJU Type of offense Where When What happened to the charge? (Circle one) o 71 Convicted Dismissed Deferred Suspended Plead Guilty. 7. Have you been arrested / charged with any traffic offenses in the last five years? -, I UT— Type of offense Where When ZD Syet-v Lf> vv)1sWr ticcor C"T4 4i"u-ro Cq�e-1 \91ftic strwA— lX 1 /aecxHwq sr ib A(1 �t[� -%v t~ ccuncw PCNN 4 4rcv.n 1c VC-aw Ua ed 3 I hat happened to the charge? (Circle one) Convicted Dismissed Deferred Suspendedead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? /✓G 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) (SECOND ANU NCI IARY) 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). I here certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number 155 i 29i} 9 issued on �k 8 b expiring on 1 �Z(7-_+ I understand that if I 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 ¢� i Date k\ $ ((o STATE OF IOWA ) o COUNTY OF JOHNSON 1 Subscribed and sworn to before me by C, I p jA K rnv*P{/ on this 'TF� day of L)o) p-,jnaf "U3. 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 da f Dr 's license O i —(Z' Z 7 i S' ature of Police Chief or designee (f--� 4 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. Office Use Only Approved application DCI report State certified driving record Website update If- 9- /8 Date Gen✓rixioRNSADGEAPPL9201eamndm.DOC 04/2018 F.VI .9 C,JIOWADOT SMARTER I SIMPLER I (LISTOMER DRIVEN www.iowadat.gov Inquiry 11/8/2018 Date: Customer 1998958 Name: Kramer, Gale M Page 1 of 2 Drbw d weew wun swWan PO Box 92041 Des Mloilie5, IA 5=69204 Pt10ne. 515.244-9124 i Fait. 375239 -ISN Certified Abstract of Driving Record DL/ID #: 556YY2949 (IA) CDL Permit Class: None Class: D Audit #: 3373059 Address: 2890 HIGHWAY 1 SW Issue Date: 11/08/2018 City/State: IOWA CITY, IA Convictions Expiration 01/12/2027 Date: Endorsements: Chauffeur 3 Restrictions: Corrective Lenses Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit 522407605 Mailing 2890 HIGHWAY 1 SW Address: None Mailing IOWA CITY, IA City/State: 522407605 Date of 1/12/1959 Birth: None Sex: M Convictions Expiration 01/12/2027 Date: Endorsements: Chauffeur 3 Restrictions: Corrective Lenses Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit None Expiration Date: None CDL Permit None Endorsements: 01/07/2016 CDL Permit None Restrictions: Wgshingto—PI ID Status: None DL Status: VAL CDL Status: None CDL Permit ELG Status: 01/07/2016 CDL Cert Status: None CDL Med Status: None 'itation Date Conviction Date ACD Explanation .IUR County!�� 12/03/2015 01/07/2016 S92 Speed -IA Wgshingto—PI )2/19/2016 03/15/2016 M14 Fail to Obey Traffic Sign/Signal IA 1Dbnson .wl 12/06/2018 03/08/2018 072 Fail to Have Vehicle Under Control dA- 7oTinson -� Accidents - Accident involvement indicated does NOT mean the individual was at fault or givens citation. Accident Date IUR Case Number 32/19/2016 IA 908962 )2/06/2018 IA 1031856 Name: Kramer, Gale M DL/ID: 556YY2949 (IA) Pursuant to Iowa Code §321.10, I, Darcy Doty, 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: http://172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 11/8/2018 ARTS Name: Kramer, Gale M DL/ID: 556YY2949 (IA) Page 2 of 2 11/8/2��20018��^��^''' Driver & Identification Services Iowa Department of Transportation http://172.29.254.55/drivers/reports/customerhistorylcertifieddrivingrecord.aspx 11/8/2018 Oct.31,2018 9:39AM Div of Criminal Investigation 101=4VID i u:).3 Y enow Cab STATt OF'X-.OWA. 'CrImbul Mst"yReiedM -C . hetk Reqttest Forin Tot- nyest% gation SuPpotiapdA , dowk 1"Iftor. xsk;iow , Ad Deg Malbbli k** qw . 725-1.5066 - M01 0 -.NK . I am recraeatinsr an:TavvwrrhAw uwiro*-hra nmL-,..... ITAX)319 338 21Nudo. 0537 P. r.1 0021002 D0ACZouutN=ber-,19967-F Frena 428 'I6wz'QtY.,TA. 52U4 (W) 339-7002 MI77(01�5110) Received Time Oct. 30. 2018 10:11AM No, 0349 (DCI we arly) L45— AS Of, geafl& alhe PIOVMrA naiw.40d dM dbhlh Woale& �j Nq Iowa -r-A=igd-HI9ory Rwordfound With MI oto CAMkIaLtdoory, recordnway not ber-re%&MbI*;pAr:"& hrrowi; C-6qur Osea, For SMP—Igt6 'climinal MAory-vem-,d lufoiwixoo iAIIQwsd*bj.;aw,&jwayi /R rn c, ; ❑ Nininal MI77(01�5110) Received Time Oct. 30. 2018 10:11AM No, 0349 (DCI we arly) AS Of, geafl& alhe PIOVMrA naiw.40d dM dbhlh Woale& Nq Iowa -r-A=igd-HI9ory Rwordfound With MI '`.. s` /R rn c, ; ❑ Nininal IaP4 Hislary Record atraeh4 DC C-1 DCI fifidta *Z: r MI77(01�5110) Received Time Oct. 30. 2018 10:11AM No, 0349 00.31.2018 9:39AM Div of Criminal Investigation No.0531 P. 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 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 certain juvenlle sex offenses can be found on the Iowa Sex Offender Registry: http://www.iowasexoffender,com/. However, even though some Information Is available on this site, the actual records for juvenlles may still be confidential and any confidential 0iuvenile records cannot be provided with this record. In order to request the release of confidential juvenllo records, if any, an application must be filed pursuant to Iowa Code section 232,147(18).