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HomeMy WebLinkAbout19-014'In �1., CITYF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) _ 2. Address (REQUIRED) _ IDENTIFICATION NO. (Office Use Only) APPLICATION FOR TAXiCAi31 MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday) Failure to complete the "rep tred" information will result in denial of the application J1 Middle 3. Contact Information (REQUIRED) Email: Cell Phone:"�J� -q_ 6 'j (All written comm nication gent via email) 4a. Driver's License expiration date ( b. Taxicab Business Name (REQUIf 5. Prior experience in transportation 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? What happened to the charge? (Circle one) Convicted Dismissed (oe Suspended Plead /Guilty Other 7. Have you been arrested / charged with any traffic on the last five years? lcS W here When What happened to the charge? (Circle one) Convicted Dismissed Deferred SuspendePlead G ' Other 8. Has your driver's license or chauffeur's license been suspended or revoked in ast five years? Where ,C,v, & When 9. Have youlever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) AND 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 (iorm available upon request). I hereby cert hat I have issued to me by the Iowa Department of Transportation valid Driver's license number issued on 2 14 expiring on I understand that if I falsely answer any questions in this application, that this application may be denied. I ag a 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 prov'sions of Title 5, Chapter 21 of the City Code. (Needs to bee signed ) in front of a Notary Public) Signature of Applicant Date L !` STATE OF IOWA ) COUNTY OF JOHNSON I Subscribed and sworn to before me by 0-t cJ4 -*_J o�q on this 1 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 Driver's license --7 bignaturpWPolice Chief or designee o3-cb-L7 Gz - Z' - 0 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 aeWTAXORN94DGEAWL9201 BamerMeC.DOC 2-21-1 Date 04/2018 l reb.2U.2019 6:IUAM UU1 IOWA Fro m:�n ry or -ewa �.sy Clark vrnoa: 310 3666467 No. 5600 P. 1/8 02/13/2010 13:3 425 ,u /002 STATE OF IOWA 0 Criminal history Record Check Request Form To: Iowa Division of Criminal Investigation Support Operations Bureau, 1st Floor 215 B. 7'h Street Des Moines, Iowa 50319 (515) 725.6066 (515) 7254080 Fax I am reauestina an Tnwa Cr;m;nal A:a1—. ue,.....a M-_,. --. DCl Account Number: ` 0Da 'f-- (it"licablc) From, Cit df IOWA Cit City Clerks Office "— 410 E. Washlaron Street Iowa City, IA 52240 Phoue: 319356-5041 Fax: 319-356.5497 Last Name (mandatory) First Name (mandato;) Middle Name tracolm„a,ded Date of Birth©(maneaon) Gender (mulduory) Social SecurityNumber (mcommeoaw) b 3 Male []Female WaiVerinfortnafion: Without a signed waiver from thesubjeet 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 subject ottbe reqUest. Waiver,Release• t busby yvs pe m at;on for the Wove repUutina official to conduct an Iowa criminal history record chcca with the Division of criminal Invesdgslion (DCO. any a;m;Ml hiuory dAwningu that it maintamod ey the DCI may be released es allowed by law. WaiverSignatar HCl use only) , As ofi�.�a search of the provided name and date of birth revealed: -r 0 c r' ❑ No Iowa Criminal History Record found with DC1 C17 V—lowa Criminal History Record attached, DC1 # I `� S; 0 ? m In DCI initials_ Lid -11 kvw/a/!u/ Received Time Feb. 13. 2019 1:23PM No.4524 Feb.20.2019 8:18AM DCI IOWA " IOWA CRIMINAL HISTORY DCI 00494557 COURT DISPOSITION PENDING PAGE 1 OF 1 STATUS UNKNOWN DATE PRINTED - 2019/02/19 DCI:00494587 NAME: HOPE,MICHAEL GLENN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19660306 M W 602 320 BLU BRO FAR IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19950207 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA124-401-3 POSSESSION SCHEDULE I -MARIJUANA TRK#: 014615501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- OS IA STATUTE: IA123-401-3 POSSESS CONTROLLED SUBSTANCE/SCHEDULE I/MARIJUANA TRK#: 014615801 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19950707 PROBATION lY 19950707 COMMUNITY SERVICE 100H 19950707 No.5600 P. 2/8 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 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(15). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: httpi//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 232.1471161. 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. v DIVISION OF CRIMINAL INVESTIGATION Q10WAA00 DOT www.iowadot.gov SMARTER I SIMPLER 1 CUSTOMER DRIVEN g orivar S Idwltlficason a.ryb3 - PO Box M I Des MOM. U 5090EM . Phone. 515444.9124 ( Fax 51623961637 Inquiry Date: 2/21/2019 Customer #: 3239199 Name: Hope, Michael Glenn Address: 459 S SCOTT BLVD City/State: IOWA CIT', IA 522455527 Mailing 459 S SCOTT BLVD Address: Mailing IOWA CITY, IA 522455527 City/State: Date of Birth: 3/6/1968 Sex: M Convictions Certified Abstract of Driving Record DL/ID #: 155AC4503 (IA) CDL Permit Class: None Class: D CDL Permit Issue None Date: Audit #: 3626941 CDL Permit None Iowa Department of Transportation Expiration Date: Issue Date: 02/21/2019 CDL Permit None Endorsements: Expiration Date: 03/06/2027 CDL Permit None Restrictions: Endorsements: Chauffeur 3 ID Status: None Restrictions: Corrective Lenses DL Status: VAL Restriction None CDL Status: None Supplement: CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: None History Information :station Date Conviction Date ACD Explanation JUR County )5/26/2016 06/28/2016 Improper Registration IA Johnson Accidents - Accident Involvement indicated does NOT mean the individual was at fault or given a citation. tccident Date JUR Case Number )9/21/2015 IA 879405 Sanctions rype Effective End ACD Explanation JUR Occurrmce JUR suspended ',10/05/2016 .10/06/2016 ID53 Non -Payment of Iowa Fine IIA ]A Name: Hope, Michael Glenn DL/ID: 155AC4503 (IA) Pursuant to Iowa Code 4321.10, 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: 2/21/2019 ^matt. Driver & Identification Services Iowa Department of Transportation