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Home My WebLink About19-030CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319)356-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) IDENTIFICATION NO. ,� 01 --P 31D (Office Use Only) HLED D APF�KeBI('1M¢OR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday— Friday) City Clerk Failure MIAM(Wfth Yreauired" information will result in denial of the anolication 2. Address (REQUIRED) / / 0 3. Contact Information (REQUIRED) 4a. Driver's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa First Phone:3 / 9 -3 Z /- O email) 04-0%-�20z.7-- 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Where / When 1U4J4 (-r-1—a -R—/%— O euYtGAt U'Sf hs -o' 1-7, .1 C � 7Ci / / What happened to the charge? (Circle Convicted 7. Have you been arrested / charged Type of offense What happened to the charge? (Circle one) sed Deferred Suspendei Plead Guilty Other traffic offenses in the last five years? Where When 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 Where When I*] 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) /t/_0 (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 Department of Transportation a valid Driver's license number / 9. S q (C 9) 5 6 issued on �- Q - ! `f expiring on "-2 —� 1 understand that rf I falsely answer any questions in this application, that this application 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, ff 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 " Date STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by ;e Rc., PJ , l e� 5 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 s license G 7: Sign/,tL a of 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. Signat re of City Cle4 or designee Date Office Use Only Approved application DCI report State certified driving record Website update Geh✓ "IDRN64DGEAPPL92018ame W.DOC APR 0 3 2019 City Clerk Iowa City, Iowa 04/2019 I'M I. L7• LV II 4:4oriri Ul.I IUIYH No. 2638 P. 3/5 03125!2019 12:32YdowCob M19338m P.0021002 i STATE OF IOWA � L L t CrxmzhaZ Higtor,Y Record Ch-edtff! 0 3 2019 Request Porm City Clerk Iowa City, Iowa 't To: Iowa Division of Crlmjnal Invesiliatfoa Support OperationsBgresu 1"Floor 21519.7" Street" Des hfolnes,lowa 50319 (515) 72S*or66 (515) 725-6080 Irak an Iowa GPw ; S )SCI Aocouirt Number. 9967-F (if appileebie) From: Yellow Cab of Iowa C1 P.O. Box 428 IowaCity, a-52-24-4 (319) 838 9777 Phone Pax; (319) 339-7302 ...--•w..., Maooemry) �$OC,I81•$tLuElk Number (mcammeaded i Mata ❑Female' _ O _ C -2ivePrnfp/•y/ra'tipn� •(yit.(,out a signed waiver from the subject oPthe J ~ obtain ain a able, per Code of Iorya, Chapter 6,421- For corn iete eNminai hls p t' a complete criminal history reoord q,ay not obtain a waiver sl attire from the sob eetof the r west ry'record inforatgttou, ay allowed by law, alwa s y Waiver Rekase: t.heeby give pemiarloo for the idwa Imatiaetlon (DCI). Any oritnkW h' '�rY dam Oencanb.r m,,, wYaiver sisnayu, i ot);lolel io aondiwt m Iowa cr6nlnal bbbxy t rd check wid, tete DNYeloa of Comiml vin*4 by%the DCI mey be roloa>eQ asdlowed bylaw, a a search of the provided name and date of birth nbvealod: No 10Wei Criminal Iiiato y Record found with DCI Iowa Criminal History record aiiaohed,'i}CT / DCI u ius � DCI -77 (08/25/10) Oct we only) STATE OF IOWAJDPS MAR 2 5 2019 / OF GMMINAI- INIVEfi 67. LV 17 Y•'t 71'Itl UVI ivnn No. 2638 P. 4/5 IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI:00967322 NAME: LSWIS,TERRY N LEWIS,TERRY NEIL DOB SER RAC HGT NGT 19570404 M B 602 210 19570407 DCI 00987322 PAGE 1 OF 2 DATE PRINTED- 2019/03/29 I E APR 0 3 ZU19 EYE HAIR SRN POB City Clerk BRO ELK DRK AR IOWA CI . t5! Iowa ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20170217 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J.2(2)(A) OPERATING WHILE UNDER THE INFLUENCE 1 TRK#: IA000VM01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46(2) PUBLIC INTOxICATION let Offense COURT CASE ID: 06521 OWCR114732 CHARGE CLASS: MISDEMEANOR CONVICTION TRM 1A000VM01 SENTENCE DISP EFF DAT FINE $100.0 20170731 COMMUNITY SERVICE MAY DO COMM SERVICE IN LIEU 20170731 OF PAYMENT 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(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 he 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 I5 Mar -29.2019 4:49PM DCI IOWA No. 2638 P. 5/5 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD - COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION APR 03?019 City Clerk Iowa City, low, Name: Lewis, Terry Neil DL/ID: 795AK9286 FILED APR 0 3 7n. 24 1 A D OT City Clerk I City, Iowa ~—� S6t.RRTER I SIMPLER I CUSTOMER DRNEt; wtimiowadot.gov Driver & idontigeation Services PO Eox 9r,- ! Des taches. IA 633C692W Phcne 515-244-9171 Fax 51F�299-1897 Certified Abstract of Driving Record Inquiry Date: 3/25/2019 DL/ID #: 795AK9286(IA) Customer #: 6098942 Name: Lewis, Terry Neil Class: C ID Status: None Address: 1100 ARTHUR ST Audit #: 7959286 DL Status: VAL APT 136 Issue Date: 04/08/2014 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 04/07/2022 CDL Cert Status: None 522406606 Endorsements: NONE CDL Med Status: None Mailing Address: 1100 ARTHUR ST Restrictions: NONE Restriction None APT 66 Supplement: Date of Birth: 04/07/1957 Mailing IOWA CITY, IA Sex: M City/State: 522406606 History Information Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number 3UR 02/17/2017 969528 IA Name: Lewis, Terry Neil DL/ID: 795AK9286 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: 3/25/2019 (:14 - Driver & Identification Services Iowa Department of Transporation