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Home My WebLink About19-0091 r CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) IDENTIFICATION NO. n — 0 (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 2. Address (REQUIRED) JXJT 3. Contact Information (REQUIRED) Email: 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) W-&)" Cell Phone:W—M via email) 17 5. Prior experience in transportation of passengers: 3 Y eYv:-5' 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense W here 0Vea✓s490. When 4� I a pC 5 k - Z- What haAned to the charge? (Circle 7) L o nw one) Convicted Dismissed Deferred Suspended Plead Guilty 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where Wim-„ 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? Type of offense 9. Have you ever applied to Where When 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 her eby certify t� issued to me by the Iowa Departm�pI of Transportat' n a valid Driver's license number �� issued on /–(�/ 1 expiring on I understand that if I a saver any questi ns in this application, that this application may be denied. I agree that i making this application, I nt to allow agents or employees of the City of Iowa City Iowa, in their discretion, to examine any and all records and entsrelatingtoxicab driver is granted, to comply at all th all of the provision of Title 5Ch ter 2of thCitCded in front of a Notary Public) ure of Applicant 4 �' / / Date / /-7- /9 STATE OF IOWA ) COUNTY OF JOHNSON and sworn to before me by—An I +` l "r �j� }) �( _ T on this /� day of �nr,r in and"for t*-StAte of Iowa 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 Dri er'�'�nse �� - z -Z3 i _ �> - w Signatu olice Chief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA Clt* FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. C-Lp r - a a -19 Signature of City Clerk or Esignee Date rr��may�m�t+��s�e�eir� Office Use Only Approved application DCI report State certified driving record Website update G« AXIDRWMDcEAPPL92018a� 00C 04/2018 C4#10WA00T SMARTER I SIMPEER I CUSTOMER DRIVEN www.iowadot.gov Dftwf & Wenti6eation Saviors PO Boz 9204 I Des Moines, IA 50306.9204 Phone 515.244.9124 i Fact. 515.2391837 Inquiry 1/16/2019 Date: Customer 4773745 Name: Shupe, Daniel Ray Certified Abstract of Driving Record DL/ID #: 958AL2175 (IA) CDL Permit Class: None Class: D Audit #: 1533483 Address: 1813 LOWR HWY 6 RD Issue Date: 01/06/2017 EXP � NW TRLR 81 VAL v �� None Expiration 12/22/2023 Date: r�t City/State: OXFORD, IA 523229246 Endorsements: Chauffeur 3 Mailing 1813 LOWR HWY 6 RD Restrictions: Corrective Lenses Address: NW TRLR 81 Restriction None Mailing OXFORD, IA 523229246 Supplement: City/State: Date of 12/22/1956 Birth: Sex: M History Information CLEAR DRIVING RECORD Name: Shupe, Daniel Ray DL/ID: 958AL2175 (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: I=- M None None None d EXP � VAL v �� None None';'t r�t None ': q? F i Pursuant to Iowa Code §321.10, 1, 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: Name: Shupe, Daniel Ray DL/ID: 958AL2175 (IA) 1/16/2019 A212 ,Z)L �� Driver & Identification Services Iowa Department of Transportation Jan, 11. 2019 4:13PM DCI IOWA No. 0139 P. 1 Rrsa rn:Clty of Iowa Cl.y Clerk OIflor: 319 36e6467 o7/i4/lona 1a:49 #903 V.002/002 STATE OF IOWA a Criminal History Record Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, 1" Floor Z15 E, 1" Street Des Moines, Iowa 50319 (515) 725-6066 (515)725-6080 Fax I am reouestina an TnWn C.;rninal FT;cr..,., P.—A ri...,U DCI Account Number: a (if applicable) 4 From: City of Iowa City City Cleric's Office 410 E. Washington Street —' Iowa City, IA 5224D Phone: 319-356-5041 Fax; 319-356-5497 Lost Name mandatory) First rame (mandatory) Middle Name (rccooeuended) As of `- a search of the provided name and date of birth revealed: T a Y Date of Birth (mandato y) Gender (mandatory) Social SecuriN/umber (recommeaaea) .. ',MMale []Female � ��^ / r' Waiver Information; Without a signed waiver from the subject of the request, a complete criminal history record may not be releasable, per Code of Iowa, Chapter 692.2. For complete criminal history record information, as allowed by law, always obtain a waiver signature from the suNeet of the request Waiver Release: t hereby give pelminion for nx ebovc rcquesling official to conduce m Iowa criminal bide record cheek whh the oivision afCrihalnet Invatioacial (DCI). Any criminal hlsmry data concenune tat is malnfalned by l DC y be r eased es d by law, Waiver Signature: �y aua.a uaawa L<Ga.Vl la \.aaGCA rkt:bults (�l use only) 1 As of `- a search of the provided name and date of birth revealed: T a ` z � m .. O ElO No Iowa Criminal History Record found with DCI > t. o Iowa Criminal History Record attached, DCI #� y < i io o to DCI initials DCI -77 (08!25/10) Aer,;,,.A Tim, Ice 1A 9n10 1-1FPM Nn DA9J , Jan. 17. 2019 4:13PM DCI:00261161 NAME: SHUPE,DAN SHUPE,DAN M SHUPE,DAN R SHUPE,DAN RAY SHUPE,DANIEL RAY DOH SEX RAC 19561222 M W ADDITIONAL IDENTIFIERS SC L,HND DCI IOWA IOWA CRIMINAL HISTORY FELONY CONVICTION DCI 00261161 PAGE 1 OF 6 DATE PRINTED - 2019/01/17 HGT WGT EYE HAIR SXN POB 509 105 BRO BRO MED IA CCH RECORD ++W 01 ARRESTED/TAREN INTO CUSTODY 19000330 AGENCY: IA0940100 FORT DODGE PD CHARGE NO- 01 IA STATUTE IA716-5 CRIM NISCH 3RD DEGREE TRK#: L17418901 COURT DISPOSITION AGENCY: IA094015J WEBSTER CO DIST COURT COUNT NO- 01 IA STATUTE: IA716-5 CRIM MISC[ 3RD DEG CHARGE CLASS: MISDEMSANOR CONVICTION TRK#: L17418901 SENTENCE PROBATION 1Y SUSPENDED 90D 02 ARRESTED/TAKEN INTO CUSTODY 19571121 AGENCY: IA0520000 JOHNSON CO 90 CHARGE NO- 01 IA STATUTE IA204-401 POSS COCAINE TRK#: L17419001 CHARGE NO- 02 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L17419002 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401 POSSESSION-SCH II -COCAINE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419001 SENTENCE FINE $250 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT Nu- Oz LA STATUTE: 1Al2]-46 PUBLIC INTOX CKAK09 CLASS: MISDEMEANOR CONVICTION DISP EFF DAT 19800317 19800317 DISP EFF DAT 19880331 No. 0139 P. 2 #r O N �N " n,4 t r y � Jan. 17, 2019 4:14PM DCI IOWA No. 0139 P. 3 TRK#: L17419002 SENTENCE PLEAD GUILTY FINS $50 03 ARRESTED/TAKEN INTO CUSTODY 19880115 AGENCY: IA0480000 IOWA CO SO CHARGE NO- 01 IA STATUTE IA909-11 PROD REVOCATION TRK#: L17419101 COURT DISPOSITION AGENCY: IAO48015J IOWA CO DIST COURT COUNT NO- 01 IA STATUTE: IA908-11 PROD REVOCATION CHARGE CLASS: MISDEMEANOR CONVICTION TRX#: L17419101 SENTENCE JAIL SOD REVOKED 04 ARRESTED/TAKEN INTO CUSTODY 19890909 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- Ol IA STATUTE IA123-46 PUB INTOX TRK#: L11419201' COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 -IA STATUTE: IA123-46 PUB INTOX CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1,17419201 SENTENCE PLEAD GUILTY PAY SURCHG FINE $25 COURT COSTS 05 ARRESTED/TAKEN INTO CUSTODY 19091026 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND TRK#: L17419301 COURT DISPOSITION AGENCY: rAoS20lSJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 ONI 2ND CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17419301 OCT 00261161 PAGE 2 OF 6 DISP EFF DAT 19800405 19880405 DISP EFF DAT 19900201 19900201 19900201 Jan.11.2019 4:14PM DCI IOWA DCI 00261161 PAGE 3 OF 6 SENTENCE DISP EFF DAT JAIL 7D - 19900112 FINE $750 19900112 PROBATION 2Y 19900112 SUSPENDED 233D 19900112 CREDIT W/TIME SERVED 7R CR;SAE/TRMT;PD 19900112 SURCHG;022692 PROB VIOL - 233D 06 ARRESTED/TAKEN INTO CUSTODY 19920206 AGENCY: ZA0520200 IOWA CITY PD CHARGE 140- 01 IA STATUTE IA321J-2 OWI 3RD OFFENSE TRK#: L17419401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI 3RD CHARGE CLASS: FELONY CONVICTION TRK#: 1,11419401 SENTENCE DISP EFF DAT JAIL SY 19920414 PAY SURCHG FINE $750 19920414 07 RECEIVED 19920511 AGENCY: ZA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA321J-2-C OWI 3RD TRK#: L17419501 (OWI HOUSING) INMATE 0: 026564 CHARGE NO- 02 IA STATUTE IA321J-2-B OWI 2ND TRK#: L11419502 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2-C OWI 3RD CHARGE CLASS: FELONY CONVICTION TRK#: L17419501 SENTENCE DISP EFF DAT JAIL 5Y 19920511 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA321J-2-B OWI 2ND CHARGE CLASS: MISDEMEANOR CONVICTION No. 0139 P. 4 Jan.11.2019 4:14PM DCI IOWA DCI 00261161 PAGE 4 OF 6 TRK#: L17419502 SENTENCE DISP EFF DAT JAIL 233D 19920511 CONCURRENT W/CT 01;SENTENCE DISCHARGED 19920511 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 03 IA STATUTE: IA321J-2-C OWI 3RD CHARGE CLASS: FELONY CONVICTION TRK#: L17419503 SENTENCE CONSECUTIVE SENTENCE W/CT 01 JAIL SY CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC A 19921109 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC E 19940506 PAROLE REVOKED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC C 19950105 PAROLED CUSTODY AGENCY: TA052015M OAKDALE IMCC D 19950901 PAROLE REVOKED VIOL PROG ADMIT CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC E 19951107 PAROLED VIOL FROG CUSTODY AGENCY: IA052015M OAKDALE IMCC F 19960509 PAROLE REVOKED CUSTODY AGENCY: IA017015G ADULT PAROLE SVC G 19970124 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC H 19970509 PAROLE REVOKED FOLLOWING FINAL REVIEW HEARING CUSTODY AGENCY: IA017015G ADULT PAROLE SVC I 19970114 PAROLED W/IMMEDIATE DISCHARGE 09 ARRESTED/TAKEN INTO CUSTODY 19940127 AGENCY: IA0160000 CEDAR CO 50 DISP EPF PAT 19940506 19940506 No. 0139 P. 5 N O N N _- rn CDD .c Jan.11.2019 4:15PM DCI IOWA No. 0139 P. 6 DCI 00261161 PAGE 5 OF 6 CHARGE NO- 01 IA STATUTE IA32IJ-2 OWI -3RD TRK#: 004722201 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 01 IA STATUTE; IA321J-2 0171 3RD CHARGE CLASS: FELONY CONVICTION TRK#: 004722201 SENTENCE DISP EPF DAT PLEAD GUILTY 19940506 JAIL SY 19940506 COURT COSTS 19940506 09 ARRESTED/TAKEN INTO CUSTODY 19960103 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401(3) POSSESSION -BCH II -COCAINE TRK#: 013266201 COURT DISPOSITION AGENCY: IA052DISJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124-401-3 POSSESSION SCH II-METHAMPHSTA14INE COURT CASE ID: 06521 SRCR040178 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 013266201 SENTENCE DISP EFF DAT JAIL SSD 19960408 FINE $250 19960408 0 10 ARRESTED/TAKEN INTO CUSTODY 20000906 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA714-1-1 THEFT 2ND -,'(- TRK#: 100010901 =� COURT DISPOSITION AGENCY: TA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA714, 2(2) THEFT 2ND DEGREE - 1978 COURT CASE ID: 06521 FECROSS571 CHARGE CLASS: FELONY CONVICTION TRK#: 100010901 RESTITUTION SENTENCE DISP EFF DAT TIME SERVED 24D 20040806 FINE $750 20040806 SUSPENDED PRISON 5Y 20040806 ' PROBATION SY 20040806 Jan.17.2019 4:15PM DCI IOWA N0.0139 P. 7 DCT 00261161 PAGE 6 OF 6 PRISON 6Y 20040006 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. 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 eigned,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.iowasaxoffender.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 he filed pursuant to Iowa Code section 232.147(18). IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD,IS BASED ON INFORMATION FURNISHED. HE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT'OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION'