The URL can be used to link to this page

Home My WebLink About19-006CITYF IOWA CITY 410 East Washington Slrccl Iowa City, Iowa 52240-1826 (319) 356-5040 (319)356-5497 FAX Last 1. Name (REQUIRED) --.1 2. Address (REQUIRED) IDENTIFICATION NO. wL—M lam_ (Office Use Only) 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 3. Contact Information (REQUIRED) Email: First rtrui written comml�npation%W via email) 4a. Drivers License expiration date (REQUIRED) 2;:15 4wz -J b. Taxicab Business Name (REQUIRED) 6. Prior experienge in transportatigi) of passengers: 6. Have you ever been arrested/ charged With any misdemeanors and/or felonies in this State or elsewhere? What happened to the char e? Circle one) Convict Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense u 2� When What happened to the �ch? Circle one) �nvict 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?-� %V0� Type of offense W here W hens 0 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) -/Vd (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 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 certify that I have issued to me by the Iowa Dep rtment of Transporta' n a valid Driver's license number Z.3'� tL q 2- 5 7 issued on 5 3 expiring on Z Z 3 ZB Z . I understand that if falsely answer any questions in this application, that this ai5pli6ation may be denied. I agr a that in making this application, 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, Chapt r 2, of the C' ode. (Needs to be signed in front of a Notary Public) Signature of Applicant i z Date0i-lI-W(!i I o n STATE OF IOWA COUNTY OF JOHNSON ) y W Subscribed and sworn to before me by �� rol.i K . Ll . L 1 q,ro� on this day 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 Driv icense DI -Z3Z I -57 01 Sign�bf P ce 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. Office Use Only Approved application DCI report State certified driving record Website update /- i/ -N- Date aeM/rA%IORIVBADGEAPP02018a.e de .DOC 04/2018 C4010WADOT SMARTER I SIMPLER I CUSTOMER DRIVEN 1NWW'IOWBCi "sss Drim& idendficaWrn SerAoes PO Bac 92011 Des Mottea, lA 50306.9204 Phone: 515.244.9124IFax 615-239-1837 Certified Abstract of Driving Record Inquiry Date: 1/11/2019 DL/ID #: 253HH9257 (IA) Customer #: 389115 Class: A Name: Livingood, Prophet Kirk Micah Audit #: 9983693 Address: 412 N CLINTON ST APT 6 Issue Date: 05/05/2016 Expiration Date: 01/23/2021 City/State: IOWA CITY, IA 522456248 Endorsements: NONE Mailing 308 E BURLINGTON ST PMB Restrictions: Corrective Lenses Address: 152 Restriction None Mailing IOWA CITY, IA 522401602 Supplement: City/State: Date of Birth: 1/23/1965 Sex: M History Information Convictions CDL Permit Class: 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 None VAL VAL E� 0 ExEepted Interstate N�Oe Citation Date _ Conviction Date ACD Explanation _ 1UR c= County 05/27/2015 ,06/25/2015 IN50 ;Improper Turn ;IA ;Johnson Name: Livingood, Prophet Kirk Micah DL/ID: 253HH9257 (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 saic 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: Livingood, Prophet Kirk Micah DL/ID: 253HH9257 (IA) 1/11/2019 d ee� ds Driver & Identification Services Iowa Department of Transportation Jan. 4. 2U 19 z; vorm USI IUYIFl n . 17V1 I/� From:Cley of Iowa Cley Clork Offloa 310 3666A07 01/09/2010 11:02 0796 P.002/002 STATE OF IOWA Criminal History Record Check Request Porn] To: Iowa Division of Criminal Investigation Support Operations Bureau, 1" Floor 215 E. 7111 Street Des Mouses, Iowa 50319 (515)725-6066 (515) 725-6090 Fax DCl Account Number: Iq L706L'f�- Ofsanl- Iiumo� Front: City oflowa City City Clerk's office 430 E. Washington See 1022 Cllr, lA 52240 Phone: 319-356-5041 Fax: 319-356-5497 - I am re uestin an Iowa Criminal Histol Record Check on: Tr_eSt Nance (mandatory) First Na/me (maoaatoq) Middle Name (meoomupaed) t u! Gsed j�jYa . F f— Date Of Birlb (maldatofy) Gender (mandatory Social Security Number (recommer deer of -73 Jcld5 Male l]FemalO Waiver F2forma[ionr Without a signed waiver n-om the subject of the request, a complete criminal history record may not be releasable, per Code of Iowa, Chapter 692.2. For co. molete criminal history record Information, as allowed bylaw, always obtain a waiver sli nature from the snblect of the renaeef. Wafver ReieaSe: l hcreby siva Permission for the above requesting official to conduct an Iowa eriminal history record cheek with the llividon of Criminal Investigation (DCI). Any eriminal history dads concerning me that is maintained by she DCl may be r m oUewed bylaw. Waiver Signature: F. As of. 11 -V\. \y , a search of the provided name and date of bjt1h ® No Iowa Criminal History Record found with DCI Iowa Ckiminal History Record attached, DCI # 3$ k '7 3 (m DCI initials_-L(Z�- DCI-77 (08/25/10) o ... ,,,.,i Tl- I,„ 9 gntn in.PlAU il.. IKKA J(0cl use ohly) aled: 8 TE OF IOWA/DPS JAN - 3 2019 DIV or CRIMINAL INVEST Jan. 4.2019 2:09N N1 IUWA IOWA CRIMINAL HISTORY DCT 00381736 FELONY CONVICTION PAGE 1 OF 3 DATE PRINTED - 2019/01/04 DCI:00381736 NAME: LIVENGOD,CURT LIVEN000D,CVRT MICHAEL LIVENGOOD,KURT LIVEN000D,KURT MICHAEL LIVINGOOD,KIRK MICAH S LIVINGOOD, PROPHET KIRK M LIVINGOOD,PROPHET KIRK MICA LIVINGOOD,PROPRET KIRK MICAH PROPHET,KIRK MICA DOB SEX RAC HGT WGT EYE HAIR SKN POE 19650123 M W 509 220 BLU BRO MED IA ADDITIONAL IDENTIFIERS SC FRO SC HEAD SC RF ARM CCH RECORD **'• 02 ARRESTED/TAKEN INTO CUSTODY 19880804 AGENCY: IA0290100 BURLINGTON PD CHARGE NO- 01 IA STATUTE IA715 FORGERY TRK#: L35028901 COURT DISPOSITION AGENCY: IA029015J DES MOINES CO DIST COURT COUNT NO- 01 IA STATUTE: IA715 FORGERY CHARGE CLASS: NON CONVICTION TRK#: L35028901 SENTENCE bISP EFF DAT DEFERRED JUDGEMENT 19861003 COURT COSTS 19881003 DISCHARGED FROM 19891212 DEFERRED JUDGEMENT 02 ARRESTED/TAKEN INTO CUSTODY 19900520 AGENCY: IA0580000 LOUISA CO SO CHARGE NO- 01 IA STATUTE IA714-2-3 THEFT/3RD TRK#: 1,35029001 COURT DISPOSITION AGENCY: IA058015J LOUISA CO DIST COURT COUNT NO- 01 IA STATUTE: IA714.2(5) THEFT STN DEGREE - 1978 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L35029001 RESTITUTION SENTENCE DISP EFF DAT FINE $75 19900723 10. 19v r. [/`f .n S W C7 ,c- Jan. 4.1019 2:09FM M IUWA DCI 00381736 PAGE 2 OF 3 No. ON Y. i/4 COURT COSTS 19900723 03 RECEIVED 19920731 AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT 2ND DEGREE TRK#: L35029101 INMATE #: 062960 COURT DISPOSITION AGENCY: IAD82015J SCOTT CO DIST COURT COUNT NO- 01 IA STATUTE: IA714.2(2) THEBT 2ND DEGREE - 1978 CHARGE CLASS: FELONY CONVICTION TRK#: L35029101 SENTENCE DISP EFF DAT PRISON 5Y 19920731 CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC A 19950214 N PAROLED _ `n W/IMMEDIATE DISCHARGE -v 04 ARRESTED/TAKEN INTO CUSTODY 20041124 AGENCY: IA0480000 IOWA CO SO; - CHARGE NO- 01 IA STATUTE IA714-2(5) THEFT 5TH DEGREE W TRK#: 071614001 COURT DISPOSITION' AGENCY: IA048015J IOWA CO DIST COURT COUNT NO- 02 IA STATUTE: IA714.2(5) THEPT 5TE DEGREE - 1978 COURT CASE ID: 06461 SMAC063936 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 071614001 RESTITUTION SENTENCE DISP EFF DAT FINE $100 20041124 COURT COSTS 20041124 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. Jan. 4.1U19 2:WM Al IUWR NO. IYVI r. 4/4 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 juvenile 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 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 13 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY, DIVISION OF CRIMINAL INVESTIGATION