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HomeMy WebLinkAbout19-018it i IDENTIFICATION NO. ] of — Dl (Office Use Only) A III W 4 �®i��'t EtAn n X019 _ APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) CITY OF IOWA CITY 41 0 East Washington Street Failure to complete the "required" information will result in denial of the application Iowa City, Iowa 52240-1826 1319) 356-SO40 (319) 356-5497 FAX First Middle Last 1. Name (REQUIRED) M CG U 2. Address (REQUIRED) t Q cac /0 Z/9 I a 3. Contact Information (REQUIRED) Email'Cell Phone: ✓C? - cmmnayAllwt 0onemail)- 4a. �-1-( sent via email) 4a. Driver's License expiration date (REQUIRED) t2 / (( 10-)" b. Taxicab Business Name (REQUIRED) 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? What happened to the charge? ' cle one) Convicted Dismissed Deferred Suspended Plead Guilty 7. Have you been arrested / harged with any traffic offenses in the last five years? What happened to the charge? (Circle one) Where Other 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? N© 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) I1 96 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 h b j� v ued to me by the Iowa part ent of Transportati valid Driver's license number �V, !70!r issued on S` expiring on IJ- r ,2 c� t . I understand that if I falsely'answer 6ny tluestions in this application, that this application 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 provisjpns of ale 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant J/�\J�-r`/) [� �� tt� �� Date 2/ t et STATE OF IOWA COUNTY OF JOHNSON ) Iowleek Iowa City tow A%� Macri ed and sworn to before me by wv ; Lo on this �! 4 day of Notary Public in and for the 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 i icense Signal of Police Chief or designee 12--11- az i 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. or Office Use Only Approved application DCI report State certified driving record Website update CIeNJTAXIDft1V94DGEAPPL92018amendwDOC -4-�% Date 0412018 Qj10WA00T SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadot.gov WNW & IdWANW Sark Smile S PO Box 9XM I Dr. Moines_ IA 50306-9201 plxme 515-243-91241 Fax 515-291}18$7 Certified Abstract of Driving Record Inquiry Date: Name: Address: 2/15/2019 DL/ID #: Maeglin, David Otto Class: 2038 DEERFIELD RD Audit #: 059BB9825(IA) D 1300701 Customer #: 1387263 ID Status: None DL Status: VAL 01/21/2016 02/04/2016 N01 Issue Date: 09/15/2016 CDL Status: None City/State: MUSCATINE, IA 527618329 Expiration Date: 12/11/2021 CDL Cert Status: None Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 2038 DEERFIELD RD Restrictions: Corrective Lenses Restriction None Supplement: Date of Birth: 12/11/1959 Mailing City/State: MUSCATINE, IA 527618329 Sex: M - - History Information MAR 0.; T019 Convictionsto City Clerk ()'a City. lrnA,- Citation Date Conviction Date ACD Ex lavation CounJUR 01/21/2016 02/04/2016 N01 Fail to Yield Right of Way Muscatine IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Name: Maeglin, David Otto DL/ID: 059BB9825 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: Maeglin, David Otto DL/ID: 059BB9825 2/15/2019 doe/ r A_ _ Driver & Identification Services Iowa Department of Transporation MAR 0 1019 CitY Clerk Iowa City, Iowa State of Iowa Division of Criminal Investigation 215 E. 71h Street Des Moines, Iowa 50319 Phone: 515/725-6066 Fax: 515/725-6080 Iowa Criminal History Record Check Walk-in Rpnnact Your name: L L Address: 24 r / City/State/Zip: Phone #: Requesting an Iowa criminal history record check on: Fill in all shaded areas. Last Name Apel ido (mandatory) First Name Primer Nombre (mandatory) Middle Name Segundo Nombre (recommended) • _DAJ((i IOWA CRIMINAL HISTORY DCI 00491790 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 3 DATE PRINTED- DCI:00491790 2019/01/22 NAME: MAEGLIN,DAVID OTTO DOB SEX RAC HGT WGT EYE HAIR SKN POB 19591211 M W 511 185 GRN BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19941122 AGENCY: IA0700100 MUSCATINE PD CHARGE NO- 01 IA STATUTE IA708-2A-2B SIMPLE DOMESTIC ABUSE TRK#: 012603601 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE: IA708-2A-2B SIMPLE DOMESTIC ASSAULT TRK#: 012603801 SENTENCE DEFERRED JUDGEMENT 6M 02 ARRESTED/TAKEN INTO CUSTODY 20020214 AGENCY: IA0700000 MUSCATINE CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 1ST TRK#: 061312001 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(A) OPER VEH WH INT (OWI) / 1ST OFF COURT CASE ID: 07701 OWCRO23499 CHARGE CLASS: NON CONVICTION TRK#: 061312001 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT PROBATION 18M COMMUNITY SERVICE 40H DISCHARGED FROM DEFERRED JUDGEMENT 03 ARRESTED/TAKEN INTO CUSTODY 20030615 AGENCY: IA0700000 MUSCATINE CO SO CHARGE NO- 01 IA STATUTE IA708.2A(4) DOMESTIC ABUSE 3RD TRK#: M00167401 COURT DISPOSITION AGENCY: IA070015J MUSCATINE CO DIST COURT DISP EFF DAT 19950127 DISP EFF DAT 20020320 20020320 20020320 20031021 p/t ,f�® let, town/Cityt jowa DCI 00491790 PAGE 2 OF 3 COUNT NO- 01 IA STATUTE: IA708.2A(2)(B) COURT CASE ID: 06521 SRCRO67657 DOMESTIC ABUSE ASSAULT WITHOUT INTENT CAUSING INJURY COURT CASE ID: 07701 AGCR026983 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: M00167401 SENTENCE SENTENCE SUSPENDED JAIL 30D DISP EFF DAT TIME SERVED 2D 20030819 SUSPENDED JAIL 60D 20030819 JAIL 62D 20030819 FINE $250 20030819 PROBATION 18M 20030819 04 ARRESTED/TAKEN INTO CUSTODY 20040129 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401 (5) POSS CONTROL SUBSTANCE I TRK#: 101070401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCRO67657 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101070401 LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT SUSPENDED JAIL 30D 20040514 JAIL 30D 20040514 FINE $250 20040514 PROBATION lY 20040514 COMMUNITY SERVICE 25H 20040514 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, .most 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 IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION