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Home My WebLink About19-039IDENTIFICATION NO. 1 1 (Office Use Only) I _ �►� (�N FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police a ment review must be made between 8 a.m. to 3 p.m., Monday — Friday) CITY OF IOWA CITY City Clerk 410 East Washington Strcct Fa_iIuu(A'Lq,,CMjR tAtW "required" information will result in denial of the application Iowa City, Iowa 52240-1826 (319)356-5040 (319) 3S6-5497 FAX First Middle Last 1. Name (REQUIRED) �QS(inG \ 1 11 )l1r�n . i e r a 2. Address (REQUIRED) ? (�C)C, 3. Contact Information (REQUIRED) Email:G� o,, . \\6q%10'Z , i 0".d t" Cell Phone: 3A- b\cl 3365 jA1f'written communication sent via email) 4a. Driver's License expiration date (REQUIRED) 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? Kill Type of offense Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested/ charged with any traffic offenses in the last five years? N l7 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? 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) 04/2018 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CER�I O" DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW APR 2 9 2019 You must apply for an individual Department of Criminal Investigation Report (form availableupon request). City Clerk Iowa City, Iowa I herebyrfY that I have issued to me by the Iowa Department of Transpo tion a valid Driver's license number 3cj\t\n �\oS C issued on1 3-19 expiring on - ' - Z7) . I understand that If 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, if authorization to be a taxicab driver is granted, to comply at all times with all of the proXsions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant �A 7a_- \HCl O Q Date'1 - Z l - 1 I STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by G;o4 X41 � , �_ icc 5c1✓k. Jo- on this day of C t vas�ow �J Notary Pu c in and for the IS e of dotm 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 da a of Dr Ii nse q7 Si re of Police Chief or designee a8 -Z-5-707-7 oy-Z -'i-/ I 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. c 6 -'r- -if City I Office Use Only Approved application DCI report State certified driving record Website update 4- 2-c7-19 Date Gen✓rnx1oravan0GWPL9201e mea.Doc 0412018 o4&- 201.9 DCI IOWA ffAx)319a1No: 7006 APR 2 9 1019 STATE OF 'OW(Ay Cier la Cwinal �itsto y Redvlyd 4 Request l+orm N • To: Iowa Division of Criatillal Invesflpatioh Support Operations Bureau, 1w #1oor 215 $. 7te Street + Des Moines, Iowa 50319 (515) 725.6066 $ (515) 725-6080 pax' ` i P. 1/2J, 002 DC1 Account Number. 9967-F tifapplicable) Froml Yellow Cab ofxowa City K.U. Box 428 laws City, 7A- 52244 (319)338-9777 Phone: FIX, (319) 339-7302 0 �iVlale ❑Female I:. 5 b 3�'?3' 0512 rranw.11vormation, 'Without a signed vpaiver from the subject of the request, a complete trindnal histo record be releasable, per Code of Iowa, Chapter 692.2, For com Tete criminal h(sto history rpay not obtain a waiver A nature frofn the subieetiart�,..... �. �'! OeOrd Information, as by law, always waiver,(e%aSC I fiaroby give Pamlulos fisc thdpbovemquesting oftlelal to conduu as fowl ethanal hletetY,eee'd efieekivith the Division ofamioal lnvnq pn Ips. Any odmlrwl hCttory sate,.Foneernbig mo that Is maintelned by fpa_�Cl my be n4enxd of a11oWW by law, Waiver Signature: 9 As of g t A searel},of thoprovlded name and date ofbjlth revealed: 0 (DCt uea only) No Iowa Criminal History Record found with DCI n z .. m Iowa Ctitninal $ixory Record attached, DCI # D t� O y DCI4atlaln� - ~ DCI -77 (08125110) Received Time Apr. 12. 2019 1:48PM No. 5355 Apr.18.2019 4:39PM DCI IOWA No.7006 P. 2/2 DISCLAIMER FILF4. APR 2 9 2019 This response can only Include public criminal history dat der Iowa law, most juvenile records are, confidential. Confidential juvenile cold tderds, 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.lAvww,iowasexoffertder,eom/. However, even though some information is available on this site, the actual records forjuvenlles 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 232.947(18). W1WA D 0T APR 2 9 7019 www.iowadot.goa SMARTER I SIMPLER I CUSTOMER OhNfliJerk Drivat a ld.ntiioarq PO Box 92041 Des Manes. IA +a=tY, Iowa PhCne 515-2.44.91211Fax 51'-239-1837 CLEAR DRIVING RECORD Name: Paschal, Giovanni Pera Junior DL/ID: 351ARS658 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: Paschal, Giovanni Pera Junior DL/ID: 351AR5658 4/12/2019 C� Driver & Identification Services Iowa Department of Transporation Certified Abstract of Driving Record Inquiry Date: 4/12/2019 DL/ID #: 351AR5658 (IA) Customer #: 6841602 Name: Paschal, Giovanni Class: C ID Status: None Pera Junior Address: 2605 Westwinds Or Audit #: 3515658 DL Status: VAL Apt 1 Issue Date: 01/03/2019 CDL Status: None City/State: Iowa City IA 522464036 Expiration Date: 08/28/2027 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Addreaa: 2605 Westwlnds Or Restrictions: NONE Restriction None Apt 1 Supplement: Date of Birth: 08/28/1982 Mailing Iowa City IA Sex: M City/State: 522464046 History Information CLEAR DRIVING RECORD Name: Paschal, Giovanni Pera Junior DL/ID: 351ARS658 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: Paschal, Giovanni Pera Junior DL/ID: 351AR5658 4/12/2019 C� Driver & Identification Services Iowa Department of Transporation