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Home My WebLink About19-008CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED) _ IDENTIFICATION NO. )q� (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review mint, pe,mac bem in: 60I.m. to 3 p.m., Monday - Friday) Failure to complete the "required" information will result in denial of the aoplicadon First Middle 5 3. Contact Information (REQUIRED) Email: Kbun% - n' 3 P��.606Cell Phone: 30 ` `131 •d2b(' (All written communication sent via email) Zo2367 4a. Driver's License expiration date (REQUIRED) ( 1-2- 40 7- b. b. Taxicab Business Name (REQUIRED)IAkAIgj� C&,kj o�- lUW� CrdL.i 5. Prior experience in transportation of passengers: 16 Vin c tk Jt*- Arc) "IP 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Tvoe of offense Where When UWS F;rSY D(lan Q D+k CIrL TR D�%/Z1 i99� r rJDI1rIS�h CDt.-� t What happened to the charge? ' cle one) onvlcted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? (1 D Tvce 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? (1 0 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) r PAGE 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 Re000 (forinleyai)dble upon request). I hereby certify that I have issued to me by the Iowa pepartment of Transporta'on q valid Driver's license number 74 2 !� s( �J 3 issued on I q2u I expiring on / 7v I understand that if I falsely answer any questions in this application, that this ipplicaftion 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 A Date :��•r��e+s�«�i��s�r��+*+++�+�r�e+r��»ir��+ait«`y++�ee��++e+�»�+N+tee�r�� STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by to '4'. on this L,' 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 D ' Icense '5 6y/2�2 (y `17 of Signatu 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. Office Use Only Approved application ®DCI report _ State certified driving record _ Website update Qe AXIDRN ADGEAPPL92018amenEeE.DOC /—/(' —/ q 04/2018 00% FILED C410WADOT E SMARTER I SIMPLER I CUSTOMER DRIVER WWWV'I15UVaCkjtg0V � � Pik 1.1: 33 Drtrer a Idetaftanon SBt4iGit5 - Pd Bou 9M I Des Kloines, IA 50SWAM Phone: 515.734.91741 Fax: 315239-/697 Certified Abstract of Driving Record Inquiry Date: 1/2/2019 DL/ID #: 742A)8473 (IA) Customer #: 4760022 Name: Bunting, Kathryn Class: C ID Status: EXP Ann Address: 4451 BERKELEY LN Audit #: 3096470 OL Status: VAL Issue Date: 08/14/2018 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 08/12/2026 CDL Cert Status: None 522459308 Endorsements: NONE CDL Med Status: None Mailing Address: 4451 BERKELEY LN Restrictions: NONE Restriction None Supplement: Date of Birth: 08/12/1976 Mailing IOWA CITY, IA Sex: F City/State: 522459308 History Information CLEAR DRIVING RECORD Name: Bunting, Kathryn Ann DL/ID: 742AI8473 Pursuant to Iowa Code §321.10, I, Darcy Doty, Director of 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: Name: Bunting, Kathryn Ann DL/ID: 742AJ8473 1/2/2019 Driver & Identification Services Iowa Department of Transporation 01/Jan, 3.2019x; 9:120ceb DCI IOWA ffA)W1933e2No.7584 P. 1/51002 STATE OF IOWA CHminal History Record Check,' ' Request Form 4. DCI AccouhtNumber: `9967-F �r� (IfapPlloabfo) To: Iowa Division of Criminal Invesflgation From: _Yellow Cab of Iowa City Support Operations Bureau, 1" Floor P.O. Box 428 213 B 7"' Street Des Moines, Iowa So319 Iowa City, LA. 52244 (515) 725-6066 (515) 725-608D Fax (319) 338-9777 Phone: Fax: 19) 339-7302 I am reQuestinre an Iowa Criminal HistnrvGRer M 0%h -k �„• Last Name nunda ( ww) 1:Fii-St Name mandaw 'Middle Name (recommended) 13l•(.n-rI n G K Hey n grin Date of Birth (mandatory) Gender (ma,wmory) 'Social Security Number (rccommcndca) OTI 1Z1 l`Ir7Ly [Male �Feitiala L/ Waiver Information_ Without a signed waiver from the subject of the request, a complete griminal history record may not be releasable, per Code of Xows, Chapter 692.2- For com Tete criminal history -record Information, am allowed by law, always obtain a waiver signature from the sub act of the request. Waiver Bzlease: r hereby live petmlaelon for rhe;rbove roqucsdng oCcW to conduct an Iowa or(minel ¢lnory r000rd chock with tho ZNbion of Criminal lnvead/itlen (DCl). My oriminal hirtorydata conwmiq me. that IS maintained by the DCl maybe released ase)lowt(l bylaw. Waiver Signature: t As of 3 .� a search of the provided name and date of birth revealed: ❑ No Iowa Criminel History Record found with DCI 90 Iowa Criminal History i ecord attached, DCI 4 DCI -77 (08%25110) Received Time Jan. 2. 2019 DCI 1:23N No, 7528 0 (DCS we only) SrArF of JAN 12 1�w4,tps 7019 Cgi�1Nq` tN�Fsr Jan. 3.2019 9:12AM DC1 IOWA IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00588426 NAME: BUNTING,KATHRYN ANN DOB SETS RAC 19760812 F W ADDITIONAL IDENTIFIERS HGT WGT EYE HAIR 504 130 BLU BRO CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19981208 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI IST OFFENSE TRK#: 031202801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA 321J-2 OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 031202801 SENTENCE JAIL 48H SUBSTANCE ABUSE TREATMENT FINE $500 DCI 00588428 PAGE 1 OF 1 DATE PRINTED- 2019/01/03-- SKN 013 . .- FAR KK DISE EFF DAT 19990330 19990330 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. No.7584 P. 2/5 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 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 offensee can be found on the Iowa Sex Offender Registry: http!//www.iowaeexoffender.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