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Home My WebLink About19-003l CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED 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 l=irc4 • c � �, _ 3. Contact Information (REQUIRED) Email: f C� t?fW -CCV'O Cell Phone: 31�-113(}F`xj (Q (All written communicAtion sent via email) 4a. Driver's License expiration date (REQUIRED) _Ljo - (^ aoa ` b. Taxicab Business Name (REQUIRED) `- ne cw ao 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? Type of offense Where When What happened to the charge? (Circle one) - Convicted Dismissedeferre Suspended Plead Guilty Other 7. Have you been arrested/ charged with any traffic offenses in the last five years? Type of offense Where W he X11 testa rct�+I� tLogA14 I ilovv 2 f 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? �Ac) 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) 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 hereby cert' that I have issued to me by the Iowa Department of Transportation a valid Driver's license number �� C\ Vr issued on 31 I R expiring on bto- I(o- D �3 . 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 ApplicantDate flfYftkff}11ff1f1ff1ff1fff44fffffYfffhf1f11ff1f1ffYflff#1f11ft1f1f1f1fiYf}fflf4fefff4fy,111f1fllffifff#1111fy Y1111ff1ffl STATE OF IOWA ) COUNTY OF JOHNSON 1 Subscribed and swor to before me by A:,12- _Ae�_ o r on this _� day of �b I� Jjp wfNDYS.MAYEA 1A \ )0._X4 • e, ILk4��n 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 Driv is icense o i lure of Police Chief or designee ol-o`'-/% 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 l- 5 -/ I Date Gert Tr PDRIVEADGEAPPL92018am ,Aed.DOC 04%2018 01,�An._ I 2019j:,, 13AM Cab DCI IOWA STATZ OF 1()WA Criminal HfitbryRbcord Chkk I . Re4imt 'Form - 0C&Xl!A&1 1ftVfVtjg0L%fM r Des Moixkny�.Ioifa sojmq Ir2 1,..... q:Mlg 336 2N o-. 7584 P. . .3-/52,002 DC1 Aebount Muozbec: 9967—F fif"ucai� Fraw YQgWC9b.of1ovM Cky PM.),Iox 429 lowicfw, TA. 5W44 (3I9) 33;8.9777 Ira,. . (310),339-7302 AS of \ i �, � � � , a search of thapqMded-now and date of birth revealed: ❑ ND Iowa Ciminal -Histwy gerord f4=0 with DCI D . q initlalt�_ 7,101-77 MVTSJI QY Received Time Jan. 2 2019 10:50AM No.7441• WWOMW .3r4 0,,: J41v -2 1 Wip, aiy k -G —SqdjA&"- Sj NMber (-=�Mded) jh history neud, may not be releastblo,pej CQdo-ofrovri; cbaptoi.to ForeomI C to 0 e C rdmjnxl wig rYx*Wr4z.Mior1ikrti0 1! allowed by, law, always obtaiu..e.tetaere .aturetYomiLt est of: vest:7 wooer Rai 1AVOWWOW ofctimlng u AS of \ i �, � � � , a search of thapqMded-now and date of birth revealed: ❑ ND Iowa Ciminal -Histwy gerord f4=0 with DCI D . q initlalt�_ 7,101-77 MVTSJI QY Received Time Jan. 2 2019 10:50AM No.7441• WWOMW .3r4 0,,: J41v -2 1 Wip, aiy Jan. 3. 20 9:13AM DCI IOWA • 01 ARRESTED/TAKEN INTO CUSTODY 20170820 IOWA CRIMINAL HISTORY DCI 01075378 COURT DISPOSITION PENDING PAGE 1 OF 2 STATUS UNKNOWN DATE PRINTED - COURT DISPOSITION 2019/01/03 DCI:01075378 COUNT NO- 01 IA STATUTE: IA124.401(5) NAME: BARBER,KETNE9RA A J POSSESSION OF CONTROLLED SUBSTANCE, MARIJUANA 19T OFFENSE BARBER,KEINESHA AUDRELL TRK#: 1A00Q0M01 BARBER,KEINESHA AUDRELL JAMISES SUBSTANCE ABUSE EVALUATION BARBER,KEINE8RA JAMISES SENTENCE DISP EFF DAT DOB SER RAC NGT WGT EYE HAIR SKN POB 19920616 F B 501 095 BRO BLK DRK IL ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y TAT ABDOM TAT CHEST TAT L ANKL TAT R CALF TAT R SHLD TAT R WRS TAT UR ARM No.7584 P. 4/5 CCH RECORD +** 01 ARRESTED/TAKEN INTO CUSTODY 20170820 AGENCY: IA0520500 NORTH LIBERTY PD CNARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: 1A000OM01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(5) POSSESSION OF CONTROLLED SUBSTANCE, MARIJUANA 19T OFFENSE COURT CASE ID: 06521 SRCRI16408 TRK#: 1A00Q0M01 SUBSTANCE ABUSE EVALUATION RESTITUTION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 20180425 CIVIL PENALTY $315 CIVIL PENALTY. DEFT 20160425 raa MAY DO COMM SERVICE IN LIEU �o OF PROBATION lY 20180425 INFORMAL REVIEW 12/1/18 An arrest without disposition in not an indication of guilt. This record p 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. cn n Jan. 3.2019 9:13AM DCI IOWA No. 7584 P. 5/5 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 thio 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 232.197(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http://www.iowaeexo€fender.com/ . However, even though some information is available on this site, the actual records for juveniles 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). IN THE ABSENCE 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 N O 71 to rn OPIDWAD SMARTER I SIMPLER I CUSTOMER'NI '" � �ou+�d� ,. G11YRr B 1410*0901 t swvioa PO Ow WM I Des 1RIMA fA =1111li-WX PPWW 5154"24 t Fac 515,M1W Inquiry 1/2/2015 Date: Customer #: 6563877 Certified Abstract of Driving Record DL/ID #: 184AN7016 (IA) CDL Permit Class: None Class: C Name: Barber, Keinesha Audrell Audit #: 1847016 Jamises Address: 162 ELM RIDGE DR Issue Date: 05/31/2017 Expiration 06/16/2023 History Information CLEAR DRIVING RECORD Name: Barber, Keinesha Audrell Jamises DL/ID: 184AN7016 (IA) CDL Permit Issue Date: CDL Permit Expiration Date: CDL Permit Endorsements: CDL Permit Restrictions: ID Status: DL Status: CDL Status: CDL Permit Status: CDL Cert Status: CDL Med Status: None None None None None VAL None ELG None None Pursuant to Iowa Code §321.10, I, Darcy Doty, Driver & Identifcation Services, Iowa Department of Transp6ttation, do hereby certify that I am the custodian of the records held by Driver & Identifcation 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. i In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, .a Ankeny, Iowa this date: �b 9 c!I MENT OI iq� ore"" �so9 1/2/2019 o oFF2�at oocuDriver & Identification Services Iowa Department of Transportation Name: Barber, Keinesha Audrell Jamises DL/ID: 184AN7016 (IA) Date: City/State: NORTH LIBERTY, IA Endorsements: NONE 523179412 Mailing 162 ELM RIDGE DR Restrictions: NONE Address: Restriction None Mailing NORTH LIBERTY, IA Supplement: City/State: 523179412 Date of 6/16/1992 Birth: Sex: F History Information CLEAR DRIVING RECORD Name: Barber, Keinesha Audrell Jamises DL/ID: 184AN7016 (IA) CDL Permit Issue Date: CDL Permit Expiration Date: CDL Permit Endorsements: CDL Permit Restrictions: ID Status: DL Status: CDL Status: CDL Permit Status: CDL Cert Status: CDL Med Status: None None None None None VAL None ELG None None Pursuant to Iowa Code §321.10, I, Darcy Doty, Driver & Identifcation Services, Iowa Department of Transp6ttation, do hereby certify that I am the custodian of the records held by Driver & Identifcation 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. i In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, .a Ankeny, Iowa this date: �b 9 c!I MENT OI iq� ore"" �so9 1/2/2019 o oFF2�at oocuDriver & Identification Services Iowa Department of Transportation Name: Barber, Keinesha Audrell Jamises DL/ID: 184AN7016 (IA)